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Digitized  by  the  Internet  Archive 

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Plate. 


Photographs  of  Electric  Discharges. 


ELEMENTS 

O  F 

GENERAL 

RADIO-THERAPY 

FOR 

PRACTITION  ERS 


BY 

Dr.  LEOPOLD    FREUND, 

Vienna. 

translated   by 
G.    H.    LANCASHIRE, 

M.D.  Brix.,  M.R.C.S.  Eng.,  L.R.C.P.  Lond. 

Assistant  Physician  to  the  Manchester  and 
Salford  Hospital  for  Skin  Diseases. 

With    One  hundred  (inJ  seven  Illustrations  in  tlic  Text  and  one  Frontispiece. 


NEW  YORK 
REBMAN    COMPANY, 

lo  West  230  Street,  Cor.  5th  Avenue. 

LONDON    AGEN rs : 

REBMAN,    LIMITED 

129    SHAI'TESHURY    AVK.,    LONDON,    \V.   C. 
1904 


Entered  according  to  Act  of  Congress,  in  the  year  1904 
BY 

REBMAN    COMPANY 

in  the  Office  of  the  Librarian  of  Congress,  at  Washington 


All  Rights  Reserved 


Entered   at    Stationers'    Hall 
By    REBMAN    LIMITED,    LONDON 


BUKK   PRINTING   HOUSE 
NEW    YORK 


TRANSLATOR'S  PREFACE. 

The  translator  has  pleasure  in  introducing  Dr.  Freund's 
work  to  a  larger  circle  of  the  English-speaking  profession.  For 
the  undertaking  itself  he  feels  that  no  apology  is  needed;  Dr. 
Freund's  position  in  this  department  of  medicine  more  than 
justifies  the  enterprise.  The  author  is  known — though  the 
fact  appears  in  many  quarters  to  have  been  insufficiently  recog- 
nised— as  the  man  to  whom,  perhaps,  more  than  any  other  we 
owe  the  foundation  of  Roentgen-therapy.  The  following  pages, 
indeed,  speak  for  his  arduous  labours  in  the  whole  subject  of 
radio-therapy. 

Apologies  are  rather  needed  for  this  English  setting;  these 
are  freely  extended,  both  to  the  author,  whose  meaning  may 
possibly  have  been  in  places  misconstrued,  and  to  the  reader. 
Here  and  there  a  somewhat  free  translation  has  been  rendered 
necessary  by  the  exigencies  of  the  language — a  necessity  which 
all  readers  of  German  will  be  the  first  to  acknowledge.  In  cer- 
tain places  omissions  have  been  made  with  the  author's  permis- 
sion. 

In  conclusion,  the  translator's  grateful  thanks  are  recorded 
for  the  kindly  help  afforded  him  by  many  friends. 

G.  H.  Lancashire." 

Manchester,  January,  1904. 


AUTHOR'S   PREFACE. 

In  this  work  I  have  attempted  to  bring  the  essential  features 
of  a  recent  form  of  treatment  before  the  notice  of  a  larger 
circle  of  medical  men.  I  had  before  me  the  task  not  only  of 
describing  In  a  comprehensible  manner  the  technique,  the  Indica- 
tions for  and  results  to  be  expected  from  the  various  radlo- 
therapeutlc  methods,  but  also  of  tabulating  and  arranging  the 
fundamental  physical  laws  these  nature-forces  obey,  thereby 
more  fully  explaining  their  physiological  effects.  Six  years' 
arduous  theoretical  and  practical  work  In  all  the  branches  of 
radio-therapy  treated  of  in  this  volume  form  my  excuse  for  a 
partial  survey  of  this  department  of  medicine,  and  may  fairly 
entitle  me  to  undertake  a  work  of  this  nature. 

I  have  not  limited  myself  to  the  description  merely  of  my 
own  investigations  and  conclusions,  but  have  quoted  every  au- 
thor who  has  written  on  this  subject,  controlling  wherever  pos- 
sible his  deductions  by  my  own  experiment.  Where  it  seemed 
advisable  for  the  further  comprehension  and  investigation  of  a 
subject,  the  older  physical  and  photochemical  works  have  been 
quoted.  I  have  purposely  presupposed  but  little  knowledge 
on  the  part  of  the  reader,  as  will  be  seen  in  the  introductory 
chapters  on  physics.  I  have  tried  as  far  as  possible  to  Include 
the  most  recent  ideas,  drawing  from  the  knowledge  obtained  in 
practice  up  to  the  present  time,  while  referring  the  reader  to  the 
various  sources  which  afford  fuller  information  on  the  separate 
subjects.  Above  all,  the  present  work  makes  no  claim  to  have 
thoroughly  exhausted  Its  subject,  nor  must  the  conclusions  ar- 
rived at  be  considered  infallible.  It  is  a  truism  that,  however 
complete  an  observer's  knowledge  may  seem  to  be,  in  course  of 
time  fresh  facts  partly  contradict  his  earlier  conclusions. 

It  requires  but  a  brief  glance  to  show  the  enormous  amount 
of  work  which  a  large  number  of  Investigators  have  already 


vi  AUTHOR'S  PREFACE 

accomplished,  and  the  great  progress  which  has  been  made  in  a 
few  years  with  the  question  of  radio-therapy.  Such  zeal,  such 
intense  interest  as  the  most  talented  and  able  chemists,  physicists 
and  medical  men  of  every  country  have  shown  in  attacking  these 
most  difficult  problems,  remain  almost  without  parallel.  Al- 
though this  branch  of  science  can  hardly  be  said  to  be  more  than 
in  its  infancy,  gaps  in  our  knowledge  having  everywhere  to  be 
filled  and  rubbish  to  be  removed,  we  have  already  achieved  bril- 
liant theoretical  and  practical  results,  leading  one  to  hope  that 
radio-therapy  will  obtain  an  acknowledged  place  among  our 
methods  of  treatment.  One  need  only  refer  to  the  undeniable  and 
astonishing  results  achieved  in  the  department  of  skin  disease, 
which  has  so  markedly  attracted  the  attention  of  dermatologists. 
Nevertheless,  the  claims  of  radio-therapy  as  a  treatment  for  dis- 
ease are  still  disputed;  from  time  to  time  medical  men,  among 
whom  are  some  of  repute,  although  none  can  claim  personal 
experience,  feel  called  upon  to  refer  to  Roentgen-therapy,  d'Ar- 
sonvalisation,  etc.,  as  exploded  and  soon-to-be-forgotten  meth- 
ods. True,  such  croakings  may  deter  the  scientific  ardour  of 
others,  but  cannot  really  impede  the  progress  of  radio-therapy. 
"Science  is  progressive.  Its  development  is  as  necessary  and 
irresistible  as  the  tide.  It  is  also  a  stage  of  development  of  the 
natural  forces,  and  as  such  is  sure  in  due  time  to  compel  recog- 
nition, should  not  those  who  now  try  to  belittle  its  influence 
and  hinder  its  progress  prefer  to  ally  themselves  with  it."  These 
words  of  John  Tyndall,  which  were  addressed  to  the  opponents 
of  natural  science,  might  also  be  taken  to  heart  by  the  opponents 
of  radio-therapy.  If  any  of  my  colleagues  whose  work  lies  out- 
side this  field  should  feel  induced  by  my  modest  efforts  to  pay 
in  the  future  more  attention  to  this  subject,  or  even  if  they 
merely  admit  the  raison  d'etre  of  the  methods  laid  down  and 
scientifically  justified  in  this  book,  my  aim  is  accomplished.  I 
trust  that  the  fact  of  my  drawing  largely  upon  my  own  personal 
experience  and  investigation  will  not  tend  to  prejudice  the  reader 
against  my  work.  My  heartiest  and  sincerest  thanks  are  due 
to  Hofrath  Director  Prof.  Dr.  J.  M.  Eder,  Hofrath  Prof.  Dr. 
Anton  Weichselbaum,  Prof.  Dr.  Eduard  Valenta,  Prof.  Dr. 
Anton  Lampa  and  Docent  Dr.  Anton  Ghon,  who  have  light- 


AUTHOR'S  PREFACE  vii 

ened  my  otherwise  enormously  difficult  investigations  and  both  in 
word  and  deed  most  kindly  helped  me.  Special  thanks  are  owing 
to  my  highly  esteemed  teacher  Hofrath  Prof.  Dr.  J.  Neumann, 
who  has  always  followed  my  work  with  friendly  interest,  and 
has  of  late  given  me  the  opportunity  of  furthering  my  scientific 
investigations  by  placing  the  radio-therapeutic  laboratory  of  his 
clinic  at  my  disposal. 

L.  Freund. 


INTRODUCTION 

By  radio-therapy  we  mean  the  employment  of  any  form  of 
radiation  for  therapeutic  purposes.  The  name  "radiation" 
comprises  usually  a  series  of  physical  manifestations  which,  ac- 
cording to  the  present  state  of  our  knowledge,  can  be  divided 
into  two  groups  {Lampa) .  In  the  first  group  fall  electro- 
magnetic radiations  (radiations  of  electrical  energy),  heat  rays, 
light  and  ultra-violet  rays;  in  the  second  group  cathode  rays, 
Roentgen  rays,  the  rays 'emitted  by  glow-worms  (Miiravka) , 
Becquerel  rays,  radium  and  polonium  rays. 

All  these  radiations  possess  active  powers  by  reason  of  cer- 
tain inherent  physical  characteristics.  These  are  known  as 
radiant  energy.  Physicists  have  formulated  various  hypotheses 
as  to  the  character  of  this  radiant  energy.  According  to  one 
authority,  radiant  energy  is  a  form  of  activity  produced  by  the 
enormously  rapid  and  regular  vibration  of  an  imponderable  sub- 
stance, ether,  which  permeates  space  and  matter. 

Acording  to  the  number  of  vibrations  which  the  ether-par- 
ticles produce  in  a  given  second,  one  classifies  different  kinds  of 
rays,  and  the  effect  upon  our  sense  organs  varies  with  the  peri- 
odicity of  these  vibrations.  We  appreciate  vibrations  of  i6o 
to  400  billions  per  second  as  "dark  heat-rays."  If,  however,  the 
rate  of  vibration  exceeds  400  billions  per  second,  we  are  con- 
scious ot  them  not  merely  as  "heat-rays,"  but  on  account  of  their 
eflect  upon  our  eyes,  we  call  them  "light-rays."  In  this  case  the 
particular  rate  of  vibration  determines  colour  impression. 

All  ether  vibrations  which  are  under  160  and  over  790  bill- 
ions per  second  we  are  quite  unable  to  appreciate.  There  are, 
however,  ways  and  means  by  which  these  rays  can  be  brought 
within  our  visual  capacity.  Thus,  for  instance,  heat-waves  of 
great-wave  length  can  be  demonstrated  by  Langley's  bolome- 


X  INTRODUCTION 

ter,  while  short-waved  ultra-violet  rays  can  be  indicated  by  pho- 
tography or  by  the  fluorescence  of  a  platino-barium-cyanide 
screen. 

Next  in  order  to  the  well-known  ether-vibrations  of  the  heat- 
rays  comes  a  space  as  yet  uninvestigated,  which  is  succeeded  in 
turn  by  the  much  slower  vibrations  of  the  more  lengthy  electric 
waves.  In  these  latter,  according  to  Hertz,  we  have  only  i,ooo 
million  vibrations  to  the  second.  The  difference  between  light- 
waves, heat-waves  and  electric  waves  is  not  qualitative,  but 
merely  a  question  of  gradation.  Rubens  and  Aschkinass  showed 
the  most  lengthy  heat-waves  to  be  one  six-hundredth  of  a  milli- 
meter in  measurement,  vibrating  at  the  rate  of  five  millions 
per  second.  On  the  other  hand,  Lampa  has  shown  the  short- 
est electro-magnetic  waves  to  be  four  millimeters  in  length,  vi- 
brating at  the  rate  of  seventy-five  thousand  millions  per  second. 
Proceeding  now  along  the  ray-scale  from  the  large  electric 
waves  (with  wave-lengths  from  several  meters  down  to  a  few 
millimeters,  and  vibration  rates  from  a  few  millions  to  many 
milliards  per  second)  to  the  smaller  heat  and  light-waves  (with 
wave-lengths  of  0.02  millimeter  to  410  millionth  millimeter) 
we  come  to  the  still  quicker,  shorter-waved  hyper-ultra-violet 
rays  discovered  by  Hertz.  These  latter  accomplish  800  billion 
oscilliations  per  second,  and  are  distinguished  by  the  peculiar 
properties  they  possess. 


Electric 
waves 


Un- 
known 

Infra- 
red 

73 

OJ 

0! 
0 

0 

4; 

♦J 

"o 

> 

Ultra- 
violet 

Hyper- 
ultra- 
violet 

Roent- 
gen 
rays 


We  might,  perhaps,  also  include  in  this  first  group  of  radia- 
tions the  Roentgen  rays,  which  many  physicists  are  inclined  to 
regard  as  a  species  of  very  short-waved  light-rays.  The  first 
kind  of  radiations  belonging  to  the  second  group,  the  cathode 
rays,  may  be  considered  as  consisting  of  small  material  particles 
("corpuscles")  which,  like  the  ions  (see  p.  26),  are  charged 
with  negative  electricity.  According  to  Thomson's  measure- 
ments, the  material  amount  of  the  corpuscles  is,  however,  much 
smaller  than  that  of  the  electric  ions,  indeed,  only  about  one- 


INTRODUCTION  xi 

thousandth  of  the  latter,  whereas,  the  electrical  state  is  identical 

in  each  instance. 

According  to  /.  /.  Thomson,  the  corpuscle  is  com- 
posed of  a  particle  of  solid  matter  bound  up  with  a 
qualitatively  different  electric  charge.  A  broader  view, 
which  is  shared  by  a  large  number  of  investigators,  is 
comprised  by  the  conclusions  Hehnholtz  arrived  at  in 
1 8 8 1 .  Hehnholtz  observes  that  in  the  case  of  electroly- 
sis (see  p.  25)  the  ions  (charged  chemical  atoms)  are 
arranged  in  the  neighbourhood  of  the  electrodes  as  neu- 
tral bodies,  so  that  a  discharge  or  a  partial  exchange  of 
charges  of  opposed  nature  takes  place  there.  This  oc- 
currence cannot  take  place  instantaneously;  the  charges 
must  at  least  for  a  very  brief  time  lead  independent 
existences;  one  may,  therefore,  consider  that  equal 
charges  of  i  "value"  represent  the  elementary  quan- 
tity of  electricity;  or,  in  other  words,  the  electric  atom. 
Stoney  has  proposed  the  name  "electron"  for  these  elec- 
trical atoms,  a  name  now  universally  adopted.  The 
corpuscle  with  its  charge  is  identical  with  the  elec- 
tron. 

According  to  Kauffmaun,^)  the  electrical  atoms  are 
electrical  particles  which  have  the  power  of  moving  with 
a  velocity  of  1-5 — 1-3  the  velocity  of  light  in  space,  but 

I  which  are  also  able  to  assume  independent  v^ibrations 

of  their  own,  and  to  transfer  these  to  others  of  their 
kind. 'They  can  unite  themselves  with  material  particles, 
becoming  free  again,  however,  thereby  allowing  the 
manifestations  of  electrolysis.  At  the  same  time  the 
chemical  atoms  which,  charged  with  mutually  neutral- 
ising electrons,  appeared  non-electric,  discharge  or  ex- 
change their  positive  and  negative  electrons,  and  in 
doing  so  they  must  have  the  capacity  for  leading  a  sepa- 
rate existence,  if  only  for  a  short  period,  being  likewise 
able  to  freely  wander  in  the  conducting  metal.     Granted 


')  See  IV.  Kauffniann,  "Die  Entwicklung  dcs  Elcktroncnbcgriffes." 
Allg.  Naturforscherzfitung.  Jahrg.  i.  Nr.  1.  —  /i.  Lampa,  Uebcr  Strahluiig. 
Wicn    1902.       BraumiillcT. 


xli  INTRODUCTION 

now  that  you  have  positive  and  negative  electrons,  there 
is  yet  a  remarkable  difterence  between  the  two;  the  vi- 
brating electron  is  always  negatively  charged,  whereas 
the  positive  electron  remains  motionless.  Hence  it 
might  happen  that  up  to  the  present  only  negative  elec- 
trons have  been  observed,  and  it  is  quite  possible  that 
they  alone  exist.  On  this  point,  however,  no  absolute 
verdict  can  be  given.  The  electrons  have  been  also  com- 
pared with  material  atoms,  and  it  has  been  found  that 
the  former  amount  to  about  the  2-1000  part  of  an  atom 
of  hydrogen.  Thanks  to  the  electron  theory,  an  ex- 
planation is  now  possible  of  the  hitherto  obscurest  por-* 
tion  of  recent  physics,  including  cathode  rays.  Roentgen 
rays  and  Becquerel  rays.  Hitherto  physicists  have  en- 
deavoured to  explain  electrical  phenomena  by  mechan- 
ical laws;  these  attempts  have  not  proved  entirely  suc- 
cessful. Perhaps  better  results  would  ensue  from  the 
endeavour  to  explain  mechanical  phenomena  by  means 
of  electrical  theories,  and  to  assume  that  the  supposed 
inertia  of  certain  matter  is  only  imaginary.  In  that  case, 
electrons  would  be  considered  as  original  atoms,  the 
various  grouping  of  which  would  produce  chemical  ele- 
ments, and  it  would  appear  reasonable  to  look  for  the 
known  chemical  elements  amongst  these  groups  which 
happen  to  be  sufficiently  stable,  and  to  discover  a  con- 
nection between  the  relative  distribution  of  the  elements 
and  their  atomic  weights.  Finally,  we  may  hope  for  a 
solution  of  the  obscure  problem  of  gravity  by  the  aid  of 
the  electron  theory. 
The  rays  proceeding  from  the  so-called  radio-active  sub- 
stances (radium  rays,  Becquerel  rays)  may  be  classed  with  cath- 
odal rays.  This  is  evident  from  properties  all  these  rays  possess 
in  common,  viz. :  the  power  of  diverting  the  magnetic  field,  of 
causing  phosphorescent  effects,  and  of  giving  conductive  capacity 
to  gases.  We  have  in  the  radium  salts  a  class  of  bodies  capable 
of  spontaneously  emitting  corpuscles  or  electrons. 

A   cathodal-ray   electron   moving  with   enormous   velocity 
must,  on  striking  a  solid  body,  necessarily  discharge  an  electric 


INTRODUCTION  xiii 

wave  in  an  explosive  manner  into  space,  just  as  a  projectile  pro- 
duces sound-waves  at  the  moment  of  impact.  There  are  many 
grounds  for  supposing  that  Roentgen  rays  are  caused  in  this 
way/) 

This  would  form  a  second  explanation  of  the  phenomena  of 
these  mysterious  rays,  whose  remarkable  properties,  as  we  shall 
see,  many  other  theories  endeavour  to  explain.  All  these  rays 
have  this  property  in  common,  viz.,  the  power  of  exciting  phe- 
nomena in  bodies  at  a  great  distance  from  the  source  of  energy, 
without  visible  effects  upon  the  intervening  space.  (In  reality 
this  is,  however,  an  effect  which  is  transmitted  from  particle  to 
particle  into  space.) 

The  following  properties  may  be  defined  as  common  to  all 
the  varieties  of  radiation  at  present  employed  in  radio-thera- 
peutics :  They  cause  chemical  changes,  fluorescing  bodies  to 
glow,  and  alter  the  electrical  state  of  bodies  with  which  they 
come  into  contact. 

The  phenomena  above  mentioned,  discovered  for  the  most 
part  within  the  last  few  years,  have  now  also  acquired  some  im- 
portance in  medicine,  more  especially  by  reason  of  the  distinct 
and  peculiar  influence  they  exert  upon  living  organisms,  an  in- 
fluence which,  up  to  the  present,  we  have  not  been  able  to  obtain 
by  other  means.  The  result  has  been  that  we  have  been  able 
to  employ  these  various  radiative  methods  as  curative  factors 
in  certain  diseases  with  absolute  success,  and  that  this  branch  of 
treatment  undoubtedly  signifies  in  many  cases  a  distinct  progress 
in  therapeutics. 

It  is  only  of  late  that  medicine  has  turned  her  attention  to 
this  matter,  consequently,  as  yet,  her  conclusions  are  by  no  means 
exhaustive  and  the  knowledge  acquired  by  no  means  complete. 
However,  it  is  already  evident  that  besides  the  "distance-effect"^) 


^)  W.  Kauffmann,  "Die  Entwicklung  dcs  Elcctronenbcgriffcs."  —  A. 
Lampa,    "Ueber    Strahlung." 

')  By  the  expression  "distance-effect"  we  mean  in  a  physiological  sense 
the  effects  which  a  stimulation  produces,  not  at  the  site  of  irritation,  but  on 
another  part  of  the  organism  by  means  of  the  circulatory  or  nervous  system. 
Reflex  action  may  be  taken  as  an  example.  For  our  present  purposes,  how- 
ever, we  shall  consider  "distance-effects"  in  a  physical  sense ;  that  is  to  say, 
those  effects  which  the  radiations  produce  on  the  part  they  strike. 


xiv  INTRODUCTION 

common  to  all  these  radiations,  each  of  them  produces  appear- 
ances and  changes  which,  despite  certain  differences  of  degree 
rather  than  of  kind,  can  all  be  brought  into  one  category. 

At  this  juncture  we  must  refer  to  the  chapter  on  the  physio- 
logical effects  of  radiations. 

We  may  regard  these  radiations  as  physical  irritations, 
which,  like  other  (e.  g.^  chemical)  irritations,  in  small  amounts 
are  stimulating  to  granulation  tissue,  whereas,  in  stronger  doses, 
they  cause  destructive  effects.  So,  as  is  the  case  with  all  kinds 
of  excessive  stimulation,  an  over-dose  of  radiations  brings  about 
destructive  changes  and  cell-death.  It  has  long  been  a  well- 
known  fact  that  electricity  employed  in  certain  forms  promotes 
tissue-nutrition.^)  It  is  also  known  that  Roentgen  and  light- 
rays  used  with  lower  intensity  stimulate  the  growth  of  certain 
tissues  and  organisms,  as  well  as  the  proliferation  of  hairs,  col- 
ouring matter,  and  pigment. 

Moreover,  it  is  well  known  that  all  three  agencies  bring 
about  diseased  conditions  when  employed  with  greater  intensity, 
ranging  from  simple  inflammation  to  actual  necrosis. 

The  earlier  investigations  of  S.  Exner,  Kistiakowsky ,  Schaii- 
dinn,  Joseph,  Provdzek,  and  others,  have  proved  that  light, 
heat  radiations,  electricity,  and  Roentgen  rays  influence  the 
molecular  movements  of  living  cells,  certain  other  elementary 
phenomena  of  life  being  similarly  affected. 

Again,  according  to  experiment,  the  character  of  the  tis- 
sue-damage and  the  finer  molecular  changes  in  the  protoplasm 
appear  to  be  in  all  cases  similar,  whatever  be  the  particular 
agency  employed:  vacuolisation  degenerations  resulting  from 
the  action  of  light  (Glebofsky) ,  Roentgen  rays  {Gassman)  ^ 
high-frequency  electricity  (Fretind) .  With  regard  to  the  visi- 
ble clinical  effects  which  may  be  ascribed  to  radiations,  we  may, 
arguing  from  experiment,  make  the  following  definitions : 

I.  The  physiological  effect  of  a  radiation  stands  in  direct 
relation  to  its  intensity,  in  inverse  proportion,  however,  to  its 
wave-length ;  i.  e.,  other  things  being  equal,  the  short-waved  rays 


^)  The  reader  is  referred  to  the  Preface,  and  also    to    page    112,    etc., 
for  the  relations  existing  between  d'Arsonvalisation  and  radio-therapy. 


INTRODUCTION  xv 

cause   more   powerful   and   enduring   effects   than   the    longer- 
waved/) 

2.  The  signs  of  reaction  only  become  visible  after  a  latent 
period,  the  length  of  which  stands  likewise  in  inverse  proportion 
to  the  wave-length  and  intensity  of  the  radiation  employed. 

3.  The  physiological  effect  of  the  radiations  is  enduring. 

As  regards  the  penetration-effect  of  the  radiation 
we  can  lay  down  no  absolute  rule;  it  would  appear,  how- 
ever, that  this  also  bears  direct  relation  to  the  wave- 
length; that  is  to  say,  long-waved  rays  penetrate  more 
deeply  than  shorter-waved  (compare,  for  instance,  blue 
and  ultra-violet) . 

4.  Those  rays  which  have  the  property  of  exciting  fluores- 
cence (Roentgen  rays,  ultra-violet  rays,  blue  and  Becquerel 
rays)  appear  to  exert  more  physiological  effect.  Very  likely  fur- 
ther experience  and  extension  of  our  knowledge  may  tend  to 
somewhat  modify  these  definitions.  The  assumption  that  all 
the  above-mentioned  physical  phenomena  and  their  physiolog- 
ical effects  may  be  ascribed  to  the  same  or  similar  elementary 
causes,  may  claim  some  justification.  This  is  proved  by  the 
various  change-effects  which  have  been  observed  in  recent  years 
to  follow  from  different  physical  phenomena  (electricity,  light, 
etc.).  It  is  known  that  the  latter  are  not  independent  of  one 
another;  that  one  manifestation  may  call  forth  another.  Thus 
electricity  may  produce  light  phenomena,  Roentgen  rays,  ultra- 
violet, light,  and  vice  versa. 

One  cannot,  of  course,  here  attempt  a  demonstration  of 
all  those  interesting  matters  which  a  number  of  emi- 
nent physicists  have  so  ably  argued  in  favour  of  the  fore- 
going theories.  The  reader  is  referred  to  the  lucid  expositions 
of  Kayser'-),  Jaiimann'-^) ^  and  Lecher*)^  a  careful  study  of 


')  E.  Aschkinass  and  IV.  Caspari  suppose  that  the  common  source  of  the 
eflfects  produced  by  ultra-violet,  Becquerel  and  Roentgen  rays  is  to  be  looked 
for  in  the  dissociating  power  ("ionisation")  possessed  by  all  three.  Goldstein 
holds  the  ultra-violet  light  alone  responsible.  The  author,  however,  is  inclined 
to  ascribe  an  important  role  to  fluorescence. 

^)  Lehrbuch  der  Physik.    Stuttgart  bei  Enkc  1900,  pp.  563.   , 

')  Vorlesungen  ueber  Elektricitaet  und  Licht.   Leipzig.    J.  A.  Barth,  1901. 

*)  Ueber  die  Entdcckung  der  elektrischen  Wellcn,  etc.     Ibid.    1901. 


xvi  INTRODUCTION 

which  will  amply  repay  the  worker  in  radio-therapy.  In  the 
present  work  reference  will  also  be  made  in  the  appropriate  sec- 
tions to  those  circumstances  which  justify  one  in  explaining  the 
different  physiological  changes  after  radiation  by  a  reference  to 
analogous  physical  occurrences. 


CONTENTS 


PAGE 

Translator's  Preface    -..,......  iii 

Preface           ............  v 

Introduction  ............  ix 

Contents xvii 


21. 
22. 

23- 
24. 


25. 


I.     ELEMENTS   OF   ELECTRICITY 

Positive  and  Negative   Electricity     . 
Conductors  and  Non-Conductors 
Transmission  of  Electricity       .... 

Manifestations  of  Electrical  Energy 

Electrical  Distribution,   Influence  and  Induction 

Electrical  Condensers        ..... 

Electric  Machines     ...... 

Contact  Electricity,   Galvanism,  Galvanic  Batteries 
Accumulators   ....... 

Ohm's  Law       ....... 

Technical  Measure-Units  .... 

Battery  Connections  ..... 

Ramification  of  Current  ..... 

Measurements  of  Electrical  Currents 

Heat  and  Light  Effects  of  the  Galvanic  Current 

Thermo-Electricity    ...... 

Magnetic  Effects  of  Electric  Currents 
Induction  ....... 

Spark  Induction  Apparatus       .... 

Interrupters       ....... 


II.     TREATMENT  WITH  HIGH-FREQUENCY 
CURRENTS 


High-Frequency  Currents  .  .  .  .  '       . 

Instruments  for  High-Frequency  Currents 

Technique  ......... 

Physiological  Effects         ....... 

(a)     Effects  on  the  Body  Surface  of  the  Spark  Discharge 
(6)     Effects  on  Bacteria       ...... 

(c)      Histological   Experiments     ..... 

The  Therapeutic   Uses  of  High-Frequency  Currents 

Indications  for  the  Method  : 

1.  The  Induction  of  Analgesia       .... 

2.  Diseases  Associated  with   Defective  Metabolism 

3.  Tuberculosis       ....... 

4.  Nervous  Diseases       ...... 

5.  Diseases  of  the  Skin  and  Mucous  Membrane   . 
Resume      ........ 


2 
2 

5 

6 

12 

12 

17 
19 
27 
29 
32 
34 
36 
38 
41 
44 
45 
47 
56 
64 


85 

94 

100 

ici 

121 
126 

152 
165 

166 
167 
170 
172 

174 
180 


xviii  CONTENTS. 

APPENDIX 

"  Permeating  Electricity  "........  182 

III.     TREATMENT  WITH  X-RAYS 

X-RAY    METHODS 

26.  Cathode  and  Roentgen  Rays   ........  187 

27.  Vacuum  Tubes          ..........  201 

28.  Some  Practical  Hints  on  the  Installation  and  Employment  of  X-Ray 

Apparatus      ...........  215 

29.  The  Development  of  the  Therapeutic  Employijient  of  Roentgen  Rays  229 

30.  Method  of  Treatment  with  X-Rays           ......  243 

31.  Indications         ...........  261 

1.  Diseases  of  the   Hairs  and   Hairy  Regions         .          .          .  262 
Favus          ..........  262 

Sycosis  Vulgaris  and  Folliculitis  Barbae    ....  266 

Tricophytosis      .........  271 

Blepharitis           .........  271 

Trichorrhexis  Nodosa          .......  274 

Alopecia  Areata          ........  274 

Hypertrichosis    .........  276 

2.  Ulcerations  and  Skin  Diseases  resulting  in  Ulcerations    .  281 

Lupus  Vulgaris       ........  281 

Epithelioma,   Ulcus  Rodens,   Mycosis  Fungoides,  Lepra,  291 

and  Sarcoma  of  the  Skin       ......  294 

Various  Chronic   Ulcerations            .....  295 

3.  Acute  and  Chronic  Exudative   Dermatoses    and    Granula- 

tion-formations    ........  295 

Chronic  and  Acute  Eczema    ......  295 

Psoriasis           .........  296 

Prurigo  ..........  298 

Lupus  Erythematosus     .......  298 

Acne  Vulgaris,   Rosacea,   Furunculosis   ....  300 

4.  Naevus         ..........  301 

The  Treatment  of  Internal  Disorders  with  X-Rays       .          .  302 

32.  Physiological  Effects  of  the  X-Rays          ......  305 

33.  The  Active  Agent  of  this  Method 322 

34.  X-Ray  Dermatitis     ..........  337 

IV.     BECQUEREL-RAYS 

35.  Becquerel-Rays         ..........  351 

36.  Their  Physiological  Effects       ........  355 

37.  Some  Therapeutic  Experiments         .......  363 

V.     TREATMENT  WITH  HEAT  AND  LIGHT  RAYS 

ELEMENTS    OF    LIGHT-PHYSICS 

38.  Light  Theories 369 

39.  Light  Sources  .......••.•  370 

40.  Diffusion  of  Light 372 

41.  Intensity  of  Light 372 


CONTENTS. 


Photometry 
Katoptrics 
Dioptrics  . 
Aberration 
Absorption 
Dispersion 
Ultra-Red  Rays 
Ultra-Violet  Rays     . 
Light  Interference    . 
Refraction  of  Light 
Effects  of  Light 
Physiological   Effects 

1.  The  Effect  of  Light  on   Plants 

2.  The   Effect  of  Light  on   Bacteria 

3.  The  Effect  of  Light  on   Higher  Organ 
The  Therapeutic  Employment  of  Light 
(a)  Treatment  with  Sunlight 
Sunlight 
Sun   Baths 

Open-Air  Light  Baths 
Chromotherapy 
Concentrated  Sunlight 
(^)  Treatment  with  Artificial  Light  . 
Treatment  with   Incandescent  Light 
Treatment  with  Arc-Lights 
Therapeutic  Employment  of  Non-Concentrated  Arc-Light 
Employment  of  Concentrated  Arc-Lights 

♦Lupus  Vulgaris    . 


Alopecia  Areata 
Lupus  Erythematosus 
Epithelioma 
Naevus  Vascularis 
Other  Skin  Diseases 
Venereal   Diseases 
68.     ((-)  Employment  of  Other 
Spark  Light 
Incandescent  Light  . 
Fluorescence     . 
Phosporescence 
Appendix  to  the  Section  on  X 
Index  to  Subject-Matter 
Index  to  Authors    . 


Sources  of  Light 


Ray  Treatment 


373 
377 
378 

379 
380 

381 
387 

388 

391 
391 
392 
394 
395 
401 
409 
447 
450 
450 
453 
454 
455 
461 

463 
465 
479 
488 
490 
498 
509 
511 
5" 
5" 
512 
512 
513 
514 
517 
518 
520 
525 
527 
533 


LIST  OF  ILLUSTRATIONS 


Photograph    of    Electric   Dis- 
charges       Frontispiece 

PAGE 


FIG. 
I 
2 

3 
4 
5 
6 


9 

10 

II 


ge  r 


9 
17 

17 
31 
31 

31 
34 
34 
37 
39 
39 
40 

43 

49 
50 


Tension  Difference  .  . 
Carre's  Machine  .  .  . 
Wimshurst  Machine  . 
Lever-Rheostat  (Graetz) 
Lever-Rheostat  .  .  . 
Lever-Rheostat    (Reini 

Schall,  etc.)  .  .  . 
Parallel  Connection  . 
Serial  Connection  .  . 
Wheatstone's  Bridge  . 
Voltmeter,  outside  view 
Amperemeter,  outside  view  . 
12, 13  Amperemeter,  inside    view  . 

14  Crater-shaped   Depression    . 

15  Siemens's  Double  T-Magnet 

16  Gramme-ring 

17  Electro-Motive  Force  of  Alter- 

nating    Current 51 

18,  igRuhmkorff's  Coil     ...      57,     60 
20     Spark  Inductor,  with   Primary 

Coil 61 

Spark  Inductor  Contacts      .     .     62 
Spark  Inductor  Terminals  .     .     62 

Spark-gap 64 

Dessauer's      Platinum      Inter- 
rupter   66 

Dessauer's  Platinum  Break  .     .     66 

Neef's  Hammer 67 

Foucault's  Interrupter  ...  68 
Schulmeister's  Interrupter  .  .  69 
Boas'  Turbine-Mercury-Break  69 
Max  Levy's  Interrupter  .  .  . 
Mercury-break  (Reiniger,  Geb- 

bert,    etc.) 

Turbine  -  Mercury    Interrupter 
for  Alternating  Currents  .     . 
Spark-Effects   (Electrolytic  In- 
terrupter)       74 

Max    Kohl's    Electrolytic    In- 
terrupter   75 

35,36Hirschmann's     Electric    Inter- 
rupter     77.    .78 

Platinum   Interrupter  ....    "79 
Max    Levy's    Platinum    Inter- 
rupter   80 

Tesla's    Apparatus 89 

Franklin's   Plates(Condensers)     91 
D'Arsonval's  Apparatus  ...     95 
Modern  Type  of  Resonator  .     .     96 
43,44Rochefort's       Bi  -  polar       Resona- 
tor       97,     98 

45     Passage   of   Electricity   in   Ex- 
periment 4 124 


21 
22 

23 

24. 

25 
26 

27 
28 
29 
30 
31 

32 

33 

34 


37 
38 

39 
40 

41 
4^ 


70 
71 


73 


46     Experiment    22 
47,48, 49  Culture  Experiment  22 

50  Culture   Experiment  27 

51  Rabbit  Experiment  38  .     . 


135 
136 

138 
146 


PAGE 

52, 53  Culture  Experiment  43    .     .     .  147 
54, 55  Culture  Experiment  43    .     .     .  148 

56  Water-Sphere  Electrode  .     .     .  149 

57  Experiment   47 151 

58  Cell-Infiltration 153 

59  Degeneration  of  Cells  ....  154 

60  Method  of  Local  Application    .  180 

61  Crookes'    Tube 201 

62  Vacuum    Tube 203 

63  Colardeau's   Tube 207 

64  Ducretet's  Tube 209 

65  Mueller's    (Hamburg)    Tube    .  210 

66  Dessauer's   Tube 211 

67  Hirschman's  Tube 212 

68  Adjustable    Tube 214 

69  Incandescent  Lamps  as  used  in 

charging    Accumulators    .     .  218 

70  Roentgen     Apparatus     worked 

with   Accumulators  ....  219 

71  Installation  of  Roentgen  Appa- 

ratus worked  from  Continu- 
ous   Light-Current    ....  221 

72  Apparatus     with      Electrolytic 

Break 222 

73  Roentgen    Apparatus    by    Sie- 

mens and  Halske 223 

74  Auxiliaries        for        Roentgen 

Therapy 228 

75  Arrangement    of   Tube    .     .     .  249 

76  Lead     Mask 260 

77  Favus    Capilitii 264 

78, 79  Folliculitis  Barbae 267 

80, 81  Lupus     Vulgaris,    before    and 

after    treatment 283 

82, 83  Histological  changes  in  Lupus 

Tissue 287 

84, 85  Plate     Cultures    of    Staphylo- 
coccus      317,  319 

86  Hypertrichosis 333 

87  Degenerated    Swollen    Connec- 

tive-Tissue Cells 344 

88  Solar   Spectrum 386 

89  Curves     of     Thermal     Action, 

etc 388 

90, 91,92  Influence  on  the  Skin    434,  435 

93     Concentrating     Apparatus     for 

Sunlight 461 

94.95  Carbon-rods 480 

96  Iron-electrode  Lamp  (Bang)  .  485 
97,  98 Iron    Arc-Lamp    (Reiniger)     .  486 

99  Finsen's  Light  Apparatus  .  .  491 
100  Finsen's  Apparatus  ....  493 
loi  Strebel's  Light  Apparatus  .  .  495 
102, 103  Trouve's    Apparatus    .     .     .  496 

104  Apparatus      by      Lortet      and 

Genoud 497 

105  Giant-cell   of  Lupus    ....  503 

106  Lupus    Nodule 505 

107  Strebel  Instrument 515 


I. 

ELEMENTS    OF    ELECTRICITY. 


RADIO-THERAPY 


ELEMENTS  OF  ELECTRICITY/ 

§  I.    Positive  and  Negative  Electricity. 

As  is  well  known,  there  are  two  electric  states,  which  are 
complementary  to  each  other.  In  this  respect  they  may  be  com- 
pared to  positive  and  negative  quantities,  or  to  heat  and  cold. 

The  electricity  of  a  glass  rubbed  with  a  piece  of  felt 
or  leather  smeared  with  amalgam  Is  not  identical  with 
that  of  resin  rubbed  with  an  animal  skin,  for  one  of 
these  attracts  and  the  other  repels  the  electric  pendulum. 
Both  electricities  have  been  universally  termed  "/nf- 
tional  electricity,"  the  one  being  "glass-electricity"  and 
the  other  "resin-electricity."  The  former  Is  known  as 
positive  and  the  latter  as  negative  electricity.  Experi- 
ments have  shown  further  that  the  same  body  may  be- 
come alternately  positive  and  negative,  according  to 
the  nature  of  the  body  with  which  It  Is  rubbed.  For 
Instance,  If  rubbed  with  amalgam,  glass  becomes  posi- 
tive; if  rubbed  with  wool  or  fur,  negative. 

§  2.    Conductors  and   Non-Conductors. 

There  are  substances  which  transmit  electricity  with  ex- 
traordinary facility,  and  which  conduct  it  to  any  distance,  part- 
ing with  It  equally  well;  there  are  others  again  which  conduct 


')  Text-books:  Mucllcr-Pouillct.  Lchrb.  d.  Physik,  Bd.  3.  —  H.' Kayscr, 
Lehrbuch  d.  Physik.  Stuttgart  1900.  —  F.  Konicr,  Lelirb.  d.  Physik.  Wicn 
und  Leipzig  1897.  —  IV.  Pscltcidl,  Grundriss  der  Naturlchrc.  Wien  und  Leip- 
zig 1897.  —  L.  Gractz,  Die  Elcctricitaet,  7.  Anflagc,  Stuttgart.  —  /..  Grum- 
nach,  die  Physik.  Erscheinungcn  und  Kriifte.  Leipzig  1899.  —  /.  G.  IVallcn- 
tin,  Die  Generatorcn  hoch.gL-spannt(  r  l'".Krlricitaet.  Wien,  Pest,  Leipzig  1884. 
—  Colin,  Das  elcktromagnctischc  l''cld.  Leipzig  igoo.  ^- Wiedemann,  Lehre 
von  der  Elcktricitact  etc.  -  Articles  and  Lectures  by  B.  Walter.  A.  Lampa, 
E.  Lcclicr,  etc..  f|Uotid  in  the  text. 


RADIO-THERAPY 


it  with  diificulty,  and  only  part  with  it  at  places  which  happen 
to  be  touched.  The  first  arc  called  conductors,  the  second,  non- 
conductors. 

This  may  be  otherwise  expressed :  All  bodies  offer  some  re- 
sistance to  the  transmission  of  electricity.  In  non-conductors 
this  resistance  is  very  marked,  while  in  conductors  it  is  insig- 
nificant. If  a  conductor  is  meant  to  retain  its  electricity,  it  is 
necessary  that  none  but  non-conductors  be  allowed  to  touch  it. 

Hence  it  follows  that  non-conductors  are  also  insulators.  A 
conductor  can  only  remain  electrified  so  long  as  it  is  insulated, 
that  is  to  say,  surrounded  only  by  non-conductors.  Air  is  also 
an  insulator:  were  it  otherwise,  the  electricity  contained  in 
charged  bodies  would  be  rapidly  dissipated. 

There  are  no  absolute  non-conductors  of  electricity, 
hence  we  should  only  speak  of  good  and  bad  conductors. 
Those  bodies  which  stand  midway  between  these  con- 
ditions are  known  as  "half -conductors."  Pfaundler  gives 
the  following  table  of  the  known  conductors,  half-con- 
ductors, and  non-conductors,  in  which  the  various  sub- 
stances are  arranged  in  their  order  of  conductivity. 


Conductors 

Half-Conductors 

Non-Conductors 

Metals 

Alcohol 

Dry  oxides 

Coal 

Ether 

Fat 

Graphite 

Powdered  glass 

Ashes 

Acids 

Flowers  of  sulphur 

Ice  at  25° 

Solutions  of  salt 

Dry  wood 

Phosphorus 

Sea  water 

Marble 

Chalk 

Riverand  springwater 

Straw 

India-rubber 

Rain  water 

Ice  at  o° 

Etheric  oils 

Snow  (wet) 

Porcelain 

Living  vegetable  mat- 

Well-dried vegetable 

ter    , 

matter 

Living  animal  matter 

Leather,  parchment 

Soluble  salts 

Feathers,  hairs,  wool, 

Linen 

silk 

Cotton 

Jewels,  mica 

Glass 

Wax,  paraffin 

Sulphur 

Resin 

ELEMENTS  OF  ELECTRICITY  5 

The  conductivity  of  a  body  may  be  modified  accord- 
ing as  the  latter  is  soaked  or  covered  with  moisture,  as 
well  as  by  alterations  in  its  temperature,  or  the  consti- 
tution of  its  surface.  Bodies  having  a  rough  surface 
conduct  better  than  smooth.  Heat  operates  in  the  first 
instance  indirectly  by  its  drying  effect,  through  which 
bodies  lose  their  conductivity  either  wholly  or  in  part. 
On  the  other  hand,  other  bodies  become  conductive  by 
means  of  heat,  because  they  soften  or  melt.  For  instance, 
glass,  resin,  and  wax  become  more  conductive  when 
heated  so  as  to  soften.  Ice  also,  which  is  a  non-con- 
ductor at  — 25°,  becomes  a  half-conductor  when  heated 
to  0°. 
Gases  and  vapours  are  insulators  so  long  as  they  remain 
dry  and  free  from  dust. 

§  3.    Transmission  of  Electricity. 

Experiment  proves  that  electricity  which  is  produced  by 
friction,  or  by  induction  (see  §  5)  has  a  tendency  to  lie  only 
on  the  surface  of  a  charged  body.  This  phenomenon  is  ex- 
plained by  the  fact  that  similar  kinds  of  electricity  repel  one 
another  (  §  4)  ;  consequently  all  the  electrical  particles  added 
to  the  body  take  up  a  position  as  remote  as  possible  from  those 
which  it  already  contains  of  a  like  kind.  The  surface-elec- 
tricity is  called  a  charg^e. 

By  bringing  an  electrified  body  into  contact  with  a  neutral 
body,  electricity  of  the  same  kind  may  be  transmitted  to  the  lat- 
ter. 

If  an  insulated  conductor  is  allowed  to  touch  an  electrified 
body,  the  electricity  passing  into  the  former  does  not  remain 
at  the  point  of  contact  only,  but  is  distributed  o\er  the  whole 
surface.  By  repeated  contact  with  an  electrified  body  an  insu- 
lated conductor  can  be  more  and  more  charged  with  electricity. 
If  the  conductor  be  not  insulated,  but,  for  instance,  held  in  the 
hand,  any  electricity  communicated  to  it  at  once  extends  to  the 
whole  body  and  thence  to  the  earth  generally,  thus  becoming 
dissipated;  the  discharge  has  become  "earthed." 


6  RADIO-THERAPY 

Sunlight  has  the  property  of  dissipating  negative 
electricity,  also  burning  magnesium  and  electric  arc- 
light.  Polished  wires,  or  plates  of  aluminium,  mag- 
nesium, or  zinc  cannot  be  made  to  long  retain  negative 
electricity  once  they  are  exposed  to  sunlight. 

§  4.    Manifestation  of  Electrical  Energy. 

With  the  aid  of  the  electric  pendulum,  or  the  gold-leaf 
electroscope,  one  may  demonstrate  the  fact  that  similar  kinds 
of  electricity  repel,  and  dissimilar  kinds  attract  one  another. 

The  electrical  forces  which  produce  these  results  are  forces 
capable  of  operating  at  a  distance.      These  obey  the  universal 

law :  P  —  ^-~-  ;  that  is  to  say,  they  are  directly  proportional 

to  the  product  of  the  electrical  quantities  acting  upon  one  an- 
other, and  inversely  proportional  to  the  square  of  their  dis- 
tance. {Coulomb's  law.)  The  quantity  of  surface-lying 
electricity  in  a  body  is  known  as  the  electrical  density.  If  a 
body  has  a  surface  S  and  a  quantity  Q  of  electricity,  its  electric 

density  D  =  ^.  This  electricity,  owing  to  the  mutually  re- 
pelling property  of  similar  electrical  particles,  has  a  tendency 
to  spread  over  a  body  or  to  leave  It;  that  is  to  say,  it  has  a 
certain  tension  (potential),  the  amount  of  which  depends  upon 
the  quantity  or  density  of  the  accumulated  electricity,  or  the 
size  of  the  electrified  body.  Electricity  in  a  given  conductor 
can  only,  therefore,  be  considered  in  a  state  of  equilibrium 
when  the  repellent  effect  of  particles  and  the  potential  is  every- 
where the  same.  In  any  conductor  the  tension  is  everywhere 
the  same ;  not  so,  however,  the  density.  On  asymmetrical  bod- 
ies the  density  of  electricity  is  unequally  distributed,  being 
greater  where  the  curves  of  the  former  are  small.  The  smaller 
the  surface  on  which  a  given  quantity  of  electricity  is  collected, 
the  greater  the  electrical  density  in  this  region.  The  loss  of 
electricity  {point-discharge) ,  however,  increases  in  ratio  with 
the  thickness  of  the  electrical  density. 

Electricity  is  constantly  passing  into  the  dust  and 

water  particles  contained  in  the  air  surrounding  the  site 

of  this  point-discharge. 


ELEMENTS  OF  ELECTRICITY  7 

Since  like  electricities  repel  each  other,  these  elec- 
trically charged  dust  and  water  particles  become  also 
repellent,  and  so  give  rise  to  the  '' elect ric  zviud."     Just 
as  a  charged  body  can  unload  itself  at  the  discharge- 
point,  so  also,  if  connected  with  the  earth  and  placed 
opposite  another  charged  body,  it  can  exhaust  the  latter. 
This  property  depends  upon  "influence."  {See  below.) 
The  proportion  which  the  amount  of  electricity  contained  in 
a  conductor  bears  to  its  tension  depends  only  upon  the  shape 
and  size  of  the  conductor.     This  proportion  is  called  the  capac- 
ity of  the  conductor. 

.  Oiiantitv   of  electricity 

Capacity   = ' '- 

Tension 

From  this  formula  results: 

Ouantitx   of  electricitv 

Tension  =  — ^^^ : '-- 

Capacity 

By  the  electrostatic  unit  one  signifies  that  quantity  of  elec- 
tricity which  exercises  a  force  of  i  dyne  at  a  distance  of  i  cm. 
upon  an  equal  quantity  of  electricity. 

The  unit  of  energy  (dyne)  is  that  force  which  can  move 
a  mass  of  i  gramrjie  i  cm.  in  one  second. 

In  practice,  however,  one  uses  another  unit,  which  is  con- 
siderably larger  and  which  rests  upon  other  foundations.  This 
is  called  the  "coulomb,"  and  is  equal  to  3,000,000,000  electro- 
static units. 

By  the  electro-static  unit  of  tension  is  denoted  that  which 
produces  an  absolute  electro-static  unit  of  electrical  quantity  in 
a  sphere  of  i  cm.  radius. 

The  cause  of  tension  is  called  electro-motive  force.  Elec- 
tricity contained  in  a  body  can,  by  reason  of  its  tension,  do  work 
or  overcome  resistance  when  leaving  that  body.  The  amount 
of  this  capacity  for  work,  ''''electric  energy,"  depends  upon  the 
amount  of  accumulated  electricity,  and  upon  its  tension  and 
quantity  of  electricity,  and  is  expressed  in  kilogramme-metres 
(divided  by  9.8  i,  see  below.) 

The  neighbourhood  of  an  electrified  body  is  known  as  the 
"electric  field;"  within  this  7one  the  body  is  especially  active  in 


8  RADIO-THERAPY 

an  electrical  sense.      The  force  brought  to  bear  on  an  electrical 
quantity   i   is  known  as  the  electrical  field-force    {H)    in  that 
locality.      On  a  point  containing  the  electric-quantity  e  a  force 
H  e  will  be  exercised.      The  unit  has  a  field  in  which  an  energy 
of  I  dyne  is  brought- to  bear  on  an  electric  quantity  {E  Q)    i. 
In  the  same  way  a  space  in  which  magnetic  forces 
are  acting  is  called  the  "magnetic  field,"  and  the  amount 
of  the  magnetic  force,  acting  at  a  given  point  of  this 
field  on  a  unit  of  magnetism,  is  called  the  field-energy. 
In  order  to  symbolise  the  influence  which  an  electrified  and 
magnetised  body  has  on  the  surrounding  space,  the  scientist  as- 
sumes  the    existence    of   lines    of    force    proceeding  from  the 
poles  into  space.      These  in  a  manner  represent  the  energy  of 
the  poles.      For  instance,  the  expression  is  often  used  "An  iron 
core  emits  lines  of  force,"  which  conveys  the  idea  that  the  iron 
Is  magnetised,    and   possesses   magnetic   poles.     The   lines   of 
force  are  distributed  in  more  or  less  regular  curves,  according 
to  the  shape  of  the  electrified  bodies  brought  near  each  other. 
These  lines  of  force  diverge  more  and  more  as  the  distance 
from  the  emitting  body  increases.      The  field-force  of  a  given 
locality  Is  indicated  by  the  quantity  of  these  lines  of  force  con- 
tained therein;  that  is  to  say,  their  number  in  a  sheaf  whose 
sectional  area  Is  one  square  centimetre. 

Two  conductors  in  the  same  field  have,  as  a  rule,  different 
tensions.  If  we  join  the  two  conductors  by  a  wire,  they  form 
practically  one  conductor;  the  difference  in  their  respective  ten- 
sions becomes  equalised,  the  electric  particles  move  along  the 
wire  from  one  to  the  other  (from  the  body  of  higher  poten- 
tial to  the  lower)  until  a  uniform  tension  obtains.  An  "elec- 
tric current"  is  established. 

In  a  similar  manner  water,  which  Is  standing  at  dif- 
ferent levels  In  two  different  vessels  connected  by  a  tube, 
in  consequence  of  the  law  of  gravity  endeavours  to  at- 
tain one  uniform  level.  This  endeavour  is  called  te?i- 
sion;  It  represents  a  force  the  amount  of  which  varies 
with  the  respective  altitudes  of  the  two  levels.  "Ten- 
sion'' Is  synonymous  with  the  following  expressions  used 
frequently  in  electricity:   Potential,  electric  pressure,  fall 


ELEMENTS  OF  ELECTRICITY  9 

of   potential,    tension    and   pressure-difference,    etc.       A 
term  which  comprises  all  the  foregoing  is  "electro-mo- 
tive force."      F,mploying  our  water  simile   again,   this 
E.  M.  F.  varies  with  the  level  difference.    On  the  other 
hand,  the  effect  of  the  water  does  not  alone  depend  upon 
this  difference  of  level,  but  also  upon  its  quantity.      In 
one  case  an  infinitesimally  small  quantity  of  water  may 
be  acting  at  high  pressure,  in  the  other  a  very  large  quan- 
tity may  flow  from  a  slight  altitude  only.     Static  elec- 
tricity may  be  compared  to  the  former  instance,  where 
a  strong,  though  brief,  effect  is  produced,  whereas  the 
second  instance  finds  a  parallel  in  voltaic,  dynamic,  or 
galvanic  electricity,  w^here  a  considerable  and  constant 
energy  is  manifested. 
Putting  the  matter  otherwise:    If  an  electric  particle  moves 
in  an  electric  field  from  one  conductor  to  another,  the  tension 
in  these  conductors  is  not  identical;  they  have  a  "potential-dif- 
ference." 

The  work  done  by  the  motion  of  an  electrical  quantity  from 
one  conductor  to  another  is  equal  to  the  product  of  the  electrical 
quantity  and  the  tension-difference  of  the  two  conductors  (anal- 
ogous to  the  amount  of  work  accomplished  by  a  body  falling 
from  one  le\'el  to  another  under  the  influence  of  gravity.)  If 
this  electrical  quantity  equals  i  coulomb,  the  work  done  by  the 
forces  in  this  motion  is  exactly  equal  to  the  tension-difference 
of  the  two  conductors.  It  follows  that  the  tension-difference 
between  two  points  y/  and  B  of  an  electric  field  is  equal  to  the 
work  required  to  bring  i  coulomb  from  //  to  B.  Ihe  unit  of 
tension-difference  at  two  points  is  found  by  measuring  the  work 
in  kilogrammeters  required  to  move  i  coulomb  from  one  point 
to  the  other. 

In    practice,    however,    one    never   employs   this   unit,    but 

another  in  which kilogramme  of  energy  only  is  required 

to  move  I  coulomb  from  one  place  to  another.      This  unit  of 
tension-difference  is  called  i  volt. 

I  volt  X  I  coulomb  =       ,,     kijrm. 
9.CS1 


lo  RADIO-THERAPY 

The  tension-difference  of  a  place  A,  B,  or  C,  as  compared 
with  that  of  the  earth,  is  indicated  briefly  as  the  tension)  or  po- 
tential) of  that  place. 

m  r  A  B 

I I 1 1 

Fig.  I. 

Let  m  be  the  acting  mass  representing  a  point  containing 
the  electrical  quantity  -f  in,  this  point  giving  off  energy  to  the 
surrounding  space. 

According  to  Coulomb's  law,  a  repellent  force  -j-^  is  ex- 
ercised in  the  direction  d  upon  a  point  A  of  this  space  contain- 
ing  a  positive  unit  of  electrical  quantity.       The   formula     -j 

signifies  the  potential  of  the  point  A  subjected  to  the  energy  of 
7n,  or  more  briefly,  the  potential  of  A. 

If  this  point  moves  in  the  direction  of  electric  force  toward 
B,  this  force  accomplishes  work  (force  X  distance). 

The  point  A  charged  with  electricity  represents,  therefore, 
a  certain  potential  energy  in  the  electric  force-field,  which  may 
be  likened  to  that  employed  in  raising  a  weight;  this  energy 
will  be  exhausted  in  the  process  of  removal  to  an  infinite  distance 
from  m.  The  electric  potential  of  a  body  signifies  the 
capacity  for  work  of  its  electrical  tension.  The  po- 
tential A  is,  therefore,  the  work  required  to  bring  the 
electrical  unit  under  the  action  of  the  mass  m  from  A  to  infin- 
ity; or,  again,  the  work  which  must  operate  against  the  electrical 
field-force  in  order  to  bring  the  unit  of  positive  electricity  from 
infinity  to  A.  The  potential  of  the  earth  is  called  O;  one  can, 
therefore,  use  the  phrase  "from  the  earth"  instead  of  "from 
infinity."  We  can  only  observe  and  measure  differences  of  po- 
tential, or  determine  the  potential  down  to  a  "constant"  (the 
value  of  which  may  be  disregarded),  consequently,  the  poten- 
tial of  the  earth  may  be  valued  as  O. 

The  earth's  condition  is  taken  as  a  standard  for  all  meas- 
urements, and  differences  of  potential  are  compared  with  it. 
We  therefore  obtain  the  same  potential-differences  for  different 
bodies,  no  matter  what  potential  we  assign  to  the  earth. 


ELEMENTS  OF  ELECTRICITY  ii 

Tension,  like  tension-difterence,  has  i  volt  as  its  unit.  If, 
therefore,  one  speaks  of  a  tension  of  6  volts  as  obtaining  in  a 
conductor,  one  means :    The  electric  forces  acting  in  the  iield 

must  perform  a  work  6  X  — r-  kgrm.  in  order  to  bring  i  cou- 
^  9.81      ^  ^ 

lomb  from  the  conductor  to  the  earth. 

By  "surface-tension"  of  a  charge  is  understood  the  force 
with  which  electricity  is  discharged  from  a  surface.  Since  each 
"quantity''  here  acts  both  as  repelled  and  repeller,  it  is  clear 
that  this  force  must  be  proportional  to  the  square  of  the  elec- 
trical density. 

With  regard  to  this  "surface  tension,"  it  must  be  noted 
that  its  identity  with  "tension"  merely  is  not  implied.  It  is 
true  the  word  tension  is  frequently  employed  to  denote  "po- 
tential." It  would,  however,  be  more  correct  to  strictly  confine 
the  expression  to  that  force  which  drives  off  electricity  from 
the  surface  of  a  charged  conductor.  In  the  case  of  a  sphere 
the  relation  between  "tension"  of  electricity  on  the  surface  and 
"potential"  is  easily  indicated. 

Let  (T  stand  for  the  density  of  electricity  on  the  sphere;  then 
the  tension  7^  =  2  -  0"^  On  the  other  hand,  the  potential  being 
V,  E  the  whole  charge  of  the  sphere  and  R  its  radius,  then 

R 
Since  the  charge  is  equally  distributed  over  the  sphere,  the 

surface-unit  receives  the  charge  c  =  ■^,  5  being  the  surface  of 

E 

the  sphere ;  further  6  =  t^- 

4-  K 

E^ 
Moreover,  7"=:  2-0"^  =  277  -- — T—fT-.\  on  the  other  hand,  E  = 

R  V,  hence 

2  -       /v'  F'                       I  I 

T  =  ■  or  T  =  - •     V  =  ---  F'- 

167:^'         A"     '  8;rA-      '^  26 

The  points  of  an  electrical  field  whose  potentials  have  a  con- 
stant value  constitute  a  plane  surface.  No  work  is  needful 
for  moving  an  electrical  quantity  alo;ig  a  plane  surface.  At 
every  point  of  the  latter  the  force  emanating  therefrom  acts  at 
right  angles  to  that  surface. 


12  RADIO-THERAPY 

Electrical  equilibrium  can  only  obtain  in  a  conductor  if  all 
points  have  the  same  potential.  The  unit  of  capacity  is  pos- 
sessed by  that  conductor  which  receives  exactly  a  tension  of  i 
volt  from  an  electrical  quantity  of  i  coulomb.  The  unit  of 
capacity  is  called  i  farad.  In  practice  one  often  uses  the 
millionth  part  of  a  farad  as  the  unit  of  capacity.  This  is 
termed  a  microfarad. 

§  5.  Electrical  Distribution :  Influence,  Electrostatic  In- 
ductor. 

If  an  electrified  body  be  brought  near  a  non-electric  insu- 
lated body,  the  latter  becomes  also  electrified.  A  separation  of 
its  electricities  has  taken  place,  assuming  that  in  every  non- 
electric body  positive  and  negative  electricities  are  already 
present  in  equal  quantities  at  any  given  point.  The  body  acted 
upon  has  become  electrified  by  "influence,"  and  the  side  turned 
toward  the  influencing  body  becomes  the  site  of  an  opposite 
kind  of  electricity  (by  reason  of  the  mutual  attraction  of  dis- 
similar electric  particles).  This  is  known  as  "'bound"  elec- 
tricity, being  dissimilar  to  that  of  the  influencing  body;  the 
similar,  or  "free,"  electricity  escapes  to  the  side  farthest  from 
the  influencing  body. 

Experiment  shows:  i.  That  electrical  quantities  separated 
by  influence  are  inversely  proportional  to  the  square  of  the 
distance.  2.  That  they  are  directly  proportional  to  the  influ- 
encing electrical  quantity. 

§6.  Condensers. 

It  is  only  possible  to  accumulate  electricity  in  a  conductor 
up  to  a  certain  stage,  viz. :  where  its  potential  equals  that  of 
the  source  of  electricity.  If,  however,  the  charged  conductor 
has  sharp  edges  or  points,  its  potential  cannot  be  raised  quite 
to  this  standard,  since  through  these  a  certain  amount  of  elec- 
tricity is  lost  into  the  air.  (See  p.  5.)  A  "condenser"  is  an 
apparatus  assisting  in  the  storage  of  electricity  to  a  higher  de- 
gree. It  consists  of  two  metal  plates  separated  by  a  thin  insu- 
lating layer  of  varnish  or  air;  one  is  called  the  collecting-plate, 


ELEMENTS  OF  ELECTRICITY  13 

the  other  is  the  condcnsi)ig^-platc.  If  the  collecting-plate  be 
charged  to  its  utmost  capacity,  it  is  found  that  on  touching  the 
condensing-plate  with  the  finger  still  more  electricity  can  be 
received  by  the  collector.  The  explanation  of  this  is  as  fol- 
lows: When  an  "earthed"  conductor  is  brought  in  the  neigh- 
bourhood of  a  charged  conductor,  the  tension  of  the  latter  falls 
considerably,  in  consequence  of  which  it  is  enabled  to  retain  a 
still  further  supply  of  electricity.  The  capacity  of  the  collect- 
ing-plate (the  "earthed"  condenser  being  adjacent)  is  denoted 
usually  as  the  capacity  of  the  condenser.  The  capacity  of  a 
condenser  C  is  the  proportion  between  an  electrical  quantity  E 
lying  on  the  collecting-plate  and  the  tension  of  the  latter  F,  the 

condenser  being  "earthed."     We  now  have  the  formula  C  =  -^■, 

E 
from  his  F  =  -^   and  E  ^  V  C.    The  capacity  of  a  condenser 

depends  upon  the  shape  and  size  of  the  plates,  upon  their  near- 
ness to  one  another  (the  shorter  the  distance  between  the  plates, 
the  greater  the  capacity),  and,  again,  upon  the  molecular  and 
material  constitution  of  the  insulating  medium  (the  "di- 
electric"). The  condensing  capacity  is  greater  in  the  case  of 
solid  or  liquid  dielectrics  than  if  air  only  is  employed.  The 
"dielectric-constant"  signifies  the  proportion  which  the  capacity 
of  a  condenser  fitted  with  a  solid  or  liquid  dielectric  bears  to 
that  of  one  which  only  has  air  as  Its  insulating  medium.  Par- 
affin has  a  dielectric  constant  of  2.3,  india-rubber  2.9,  oil  2  to  5, 
ebonite  2.6,  vulcanite  3.15,  sulphur  3.84,  glass  6  to  10,  mica  8. 
If  an  electrified  body  be  brought  near  a  good  conductor,  the 
electricity  of  the  former  and  the  "bound"  electricity  of  the 
latter  accumulate  on  adjacent  surfaces  by  reason  of  their  mu- 
tual attraction.  If  the  electrical  density  is  In  each  case  sufficient 
and  the  bodies  are  not  too  far  apart,  the  two  electricities  com- 
bine, the  effect  being  to  produce  both  light  and  sound.  In  this 
way  an  "electric  spark"  results.  Here  the  light  Is  caused  by 
glowing  particles  passing  from  one  body  to  the  other,  the  sound 
by  air-condensation  In  the  vncinlty  of  the  spark.  As  before 
mentioned,  we  are  able  to  accumulate  large  quantities  of  elec- 
tricity by  means  of  "Influence"  or  "binding."     A  convenient  ap- 


14  RADIO-rHERAPY 

paratus  for  this  purpose  Is  to  be  found  in  Franklin's  "plate." 
This  consists  of  a  level  glass  plate  titted  with  tin-foil  on  both 
sides,  the  layers  of  metal  not  being  allowed  to  come  close  to  the 
edge. 

If  we  connect  one  of  the  tin-foils  with  a  positively 
charged  body,  positive  electricity  (+  e)  will  flow  from 
the  latter  until  the  potential  becomes  identical  with  that 
of  the  tin-foil.  In  the  second  tin-foil  electricity  becomes 
separated  by  "influence;"  negative  electricity  becomes 
attracted,  positive  repelled.  If  this  second  layer  of  foil 
be  "earthed,"  then  its  negative  electricity  becomes 
"bound,"  its  positive  electricity  flowing  away  to  the 
earth.  These  quantities  of  electricity  are  relatively  pro- 
portional to  e,  and  nearly  inversely  proportional  to  the 
distance  separating  the  respective  layers  of  tin.  They 
may,  therefore,  be  expressed  by  Ke,  K  representing  a 
fraction  of  which  the  denominator  is  proportional  to  the 
thickness  of  the  glass  plate.  Accordingly,  if  the  sec- 
ond tin-foil  be  on  the  left,  the  "binding"  takes  place 
through  -\-  e  on  the  right,  giving  — Ke  on  the  left.  The 
latter  quantity,  however,  again  binds  on  the  right  a 
quantity  -f  Ke.  One  can,  therefore,  add  K'e  to  +  £?  on 
the  right  without  any  loss  of  electricity.  This  new  quan- 
tity +  K-e  again  binds  on  the  left  —  K^e,  -\-  K^e  going  to 
earth.  This  new  quantity  again  binds  +  XV  on  the  right, 
and  so  on.  One  sees,  therefore,  that  electricity  on  the 
right-hand  plate  may  be  augmented  by 


While,    therefore,    originally   the   tin-foil   on   the   right 
could  only  receive  +  e,  it  is  now  In  a  position  to  take  up 

^——  e.     — ^-F^  =  m    is  called  the  augmenting  index. 

I  —  A ,         I  —  A , 

It  is  greater  v/hen  the  distance  between  the  tin-plates 

is  decreased. 

The  plate  on  the  right,  which  is  connected  with  the 

supply,  always  holds  more  electricity  than  that  on  the 


ELEMENTS  OE  ELECTRICEFY  15 

left,  since  in  addition  to  its  "bound"  electricity  it  con- 
tains that  which  flows  to  it  after  the  binding.  If,  there- 
fore, the  two  plates  be  joined  by  a  wire,  an  escape  of 
electricity  occurs  from  right  to  left,  accompanied  by 
sparking  at  the  moment  of  juncture. 

A  convenient  form  of  accumulating  apparatus  is  found  in 
the  Leyden  jar.  This  consists  of  a  glass  jar  with  the  tin-foil 
pasted  inside  and  out  to  2-3  of  its  height.  The  lid  is  formed 
by  an  insulating  cover,  which  is  pierced  by  a  metal  rod.  One 
end  of  this  rod  is  in  contact  with  the  inner  layer  of  tin-foil.  The 
other  end  terminates  in  a  knob.  This  rod  transmits  electricity  to 
the  inner  layer.      The  outer  layer  is  connected  with  the  earth. 

The  capacity  of  a  Leyden  jar  depends  upon  its  size;  or, 
more  correctly,  upon  the  area  of  its  tin-foils. 

A  considerable  number  of  Leyden  jars  may  be  joined  to- 
gether, forming  a  battery.  They  may  be  joined  by  connecting 
all  the  inner  and  all  the  outer  layers  respectively.  This  gives 
one  a  ccunccllon  in  parallel,  or  /;/  qitautity;  the  number  of  jars 
then  act  like  one  jar  of  n-fold  size.  Or  again,  the  outer  foil 
of  one  jar  may  be  joined  to  the  inner  foil  of  another,  and  so 
on.  This  gi\es  one  connection  /;/  series,  or  tension-connection, 
one  then  obtains  between  the  terminal  layers  the  n-fold  poten- 
tial difterence  of  a  jar,  but  in  the  discharge  the  electrical  quan- 
tity of  a  single  jar  only.  This  particular  combination  is  called 
also  a  cascade-baltery. 

If  a  Leyden  jar  be  discharged  by  a  brief  connection  only 
of  the  layers,  after  a  little  time  a  second  connection  will  produce 
another,  though  feebler,  spark.  In  the  same  way,  after  re- 
peated pauses,  a  third,  fourth,  or  more  sparks  may  be  obtained, 
each  progressively  feebler.      This  is  called  the  jar-residue. 

In  explanation  of  this  phenomenon,  it  may  be  assumed  that 
under  the  influence  of  surface-tension  electricity  permeates  the 
glass  from  both  sides;  the  surface-tension  once  removed  by  the 
discharge  electricity  slowly  returns  again  to  the  surface. 

We  have  seen  that,  dealing  with  a  sufllicient  density  and  po- 
tential (liffcrence,  an  e(]ua]ising  of  dissimilar  electricities  accu- 
mulated in  two  neighbouring  conductors  scparatctl  by  a  diclec- 
tricum  can  be  effected  in  the  form  of  a  spark.      The  amount  of 


i6  RADIO-THERAPY 

density  required  increases  with  the  thickness  of  the  insulating 
medium.  In  the  air,  the  length  of  the. spark  discharge  is 
about  proportional  to  the  density  of  the  electricity  accumulated. 
If,  however,  the  air  be  rarefied,  the  spark-length  capacity  in- 
creases, and  in  tubes  filled  with  gases  whose  pressure  only 
amounts  to  a  few  millimetres,  the  spark  length  may  advance  to 
many  metres.  These  spark  discharges  produce  many  effects. 
These  may  be  mechanical^  instanced  by  the  perforation  of  solid 
insulators,  transport  of  solid  particles  from  one  conductor  to 
the  other,  etc. ;  chemical,  causing  decompositions  or  combina- 
tions; thermic,  igniting  powder,  melting  iron  wire,  etc.;  and 
light-effects,  as  shown  by  the  visible  spark,  the  illumination  of 
Geissler's  tubes,  etc.  Finally,  feeble  magnetic  effects  of  the 
discharge  can  be  experimentally  demonstrated.  In  these  re- 
spects the  discharge  simulates  dynamic  electricity.  In  the  case 
of  powerful  discharges,  where  simultaneously  large  bundles  of 
sparks  are  emitted,  the  positive  pole  behaves  somewhat  dif- 
ferently to  the  negative.  From  the  former,  trains  of  sparks 
stream  off  from  different  portions  of  the  pole,  uniting  before 
reaching  the  negative  pole  to  strike  it  in  one  focus  only.  An- 
other kind  of  discharge  takes  place  when  there  is  but  little  re- 
sistance. If  a  powerfully  charged  Leyden  jar  have  its  two 
layers  of  foil  connected  by  a  good  conductor,  more  positive  elec- 
tricity flows  to  the  negative  layer  than  is  required  to  neutralise 
it.  This  excess  flows  back  to  the  positive  layer,  but  again  too 
freely,  so  that  a  return  again  takes  place.  In  this  way  the 
current  is  several  times  reversed  before  equilibrium  is  attained. 
This  phenomenon  may  be  compared  with  the  swinging  to  and 
fro  of  a  liquid  column  in  connection  with  two  vessels,  and  is 
called  an  oscillating  discharge.  The  number  and  duration  of 
these  oscillations  depend  upon  the  spark  length  and  the  capacity 
of  the  battery. 

Feddersen  made  searching  experiments  upon  the 
duration  of  the  electric  spark.  He  made  his  obser- 
vations upon  a  spark-reflection  in  a  rotating  mirror,  and 
saw  in  the  first  place  instead  of  a  spark-line  a  band  of 
light,  showing  that  the  spark  possessed  a  definite  dura- 
tion.    He  noticed  in  this  band  alternate  light  and  dark 


ELEMENTS  OF  ELECTRICITY 


17 


places,  a  proof  that  the  discharge  stops  and  recom- 
mences periodically.  Fcddcrsen  also  calculated  the 
period  of  these  oscillations  to  be  about  one-millionth  of 
a  second. 

§7.   Electrical  Machines. 

Electricity  may  be  continually  formed  by  friction  and  ac- 
cumulated in  an  insulated  conductor  by  means  of  Carre's  ap- 
paratus (Fig.  2).  This  consists  in  the  main  of  two  discs 
revolving  in  opposite  directions.     The  layer  of  these  discs  {B) 


Fig.  2. 


Fig.  3. 


Fig.  2. — Carres  machine  (from  "Die  Gcneratoren  hochgcspannter  Klcctricitat" 
von  Dr.  J.  G.  Wallcntin,  Wien,  Pest,  Leipzig,  Hartleben's  Vcrlag 
1884.  p.  89). 

Fig.  ,3. — Wimshurst  machine  (from  L.  Gractz  "Die  Electricitat."  Stuttgart, 
Fngelhorn,    1898,  p.   34). 

is  made  of  ebonite,  the  smaller  (//)  of  glass.  During  its  ro- 
tation the  latter  rubs  between  the  two  friction-pads  D  and  acts 
as  an  inductor.  While  this  disc  (the  glass)  revolves  compara- 
tively slowly,  the  disc  B  revolves  very  quickly.  As  seen  from 
the  figure,  these  discs  partly  cover  each  other.      Opposite  the 


1 8  RADIO-THERAPY 

ebonite  disc  B  stand  the  combs  E  and  F,  the  second  of  which 
is  connected  with  a  cylindrical  metallic  conductor  C,  the  other 
with  a  rod  T,  terminating  in  a  knob. 

This  machine  acts  as  follows :  The  positive  electricity  of  the 
rubbed  glass  disc  influences,  with  the  aid  of  disc  B,  the  comb  E 
and  draws  from  it  negative  electricity,  which  collects  on  the 
disc  B ;  the  knob  of  the  conductor  C  consequently  becomes  posi- 
tive. The  negative  electricity  of  the  dielectric  disc  draws 
from  the  comb  F  its  positive  electricity,  and  is  thereby  neu- 
tralised. The  conductor  C  itself  becomes  negatively  electric 
{W allentin) . 

This  apparatus  gives  good  results.  With  but  few  rota- 
tions, provided  the  discs  be  large  enough,  one  can  obtain  sparks 
up  to  I  ij  centimetres. 

Another  influence  machine,  which  is  often  used  for  medical 
purposes,  is  the  JVimshiirst  ( Fig.  3 ) .  This  consists  of  two 
glass  or  vulcanite  plates  placed  close  to  one  another,  each  re- 
volving round  a  common  centre,  but  in  opposite  directions. 
Each  plate  bears  on  its  outer  face  a  number  of  metal  sectors, 
and  runs  between  a  metal  fork  provided  with  spikes  pointing  to 
the  plate.  To  each  metal  fork  a  brass  rod  is  connected,  ending 
in  a  knob,  which  in  its  turn  communicates  with  a  Leyden  jar. 
Finally,  the  machine  has  an  "equaliser"  on  each  side.  This 
consists  of  a  metal  arm,  one  end  of  which  supports  a  wire  brush 
whose  bristles  rub  against  the  revolving  metal  sectors. 

On  actuating  this  machine  electricity  immediately  develops, 
which  sparks  or  "brushes"  from  knob  to  knob.  The  "equal- 
isers" are  not  placed  exactly  opposite  to  each  other,  but  at  an 
angle  of  60°  with  themselves  and  the  horizon. 

The  electrical  output  of  this  machine  is  not  due  directly  to 
friction,  but  to  the  small,  though  constant,  normal  charges  in 
the  insulated  sectors.  These  act  by  "influence,"  and  as  this 
is  the  case  not  with  one  sector  alone,  but  with  all  of  them,  the 
terminal  pole  becomes  more  and  more  powerfully  charged. 

One  cannot  enter  here  into  a  more  detailed  explanation 
of  the  action  of  this  apparatus. 


ELEMENTS  OF  ELECTRICITY  19 

§8.  Contact  Electricity,  Galvanism,  Galvanic  Batteries. 

If  two  different  metals  be  brought  Into  contact,  one  becomes 
positively  and  the  other  negatively  electrical.  This  electricity 
in  nowise  differs,  except  in  its  mode  of  origin,  from  that  pro- 
duced by  friction. 

It  is  assumed,  in  explanation  of  the  above  phenome- 
non, that  on  the  contact  of  different  conductors  an  elec- 
tro-mo five  force  appears  which  develops  positive  electric- 
ity of  a  certain  potential  on  one,  and  negative  electricity 
of  an  equally  definite  potential  on  the  other.  Each 
conductor,  therefore,  possesses  Its  own  peculiar  tension, 
a  different  value  for  each.  The  potential-difference  of 
the  two  Is  constant,  being  dependent  only  upon  the  na- 
ture of  the  metals  and  quite  Independent  of  their  size,  the 
size  of  their  plane  of  contact,  or  of  the  absolute  potential 
value  of  each  metal.  If  electricity  be  transmitted  to 
both  metals  or  to  one  of  them,  or  if  one  of  them  be 
"earthed,"  the  potential-difference  remains  the  same. 

Many  theories  have  been  advanced  as  to  the  origin 
of  this  separating  or  electro-motive  force.   Folta  thought 
that  the  mere  contact  of  the  metals  produced  their  po- 
tential-difference.     Others  have  looked  for  an  explana- 
tion in  chemical  changes  as  a  cause  of  voltaic  electricity 
{F.  Exner) . 
Volta's  experiments  with  various  metals  led  him  to  deter- 
mine a  tension-series.     This  he  arranged  In  tabular  form,  the 
first  of  the  couple  in  contact  taken  in  the  order  read  being  posi- 
tive and  the  second  negative.      This  tension-series,  also  called 
conductors  of  the  first  order,  reads  as  follows :    Zinc,  lead,  tin, 
Iron,  copper,  silver,  gold,  coal,  platinum,  manganese.      If  the 
figure    5    be  taken   as   representing  the   potential-difference   of 
zinc   and   lead    (expressed   symbolically   by   7jn/Ph^=^    5),    ac- 
cording to  Volta's  results,  we  get  the  following  values  for  dif- 
ferent combinations: 

ZnlPb  ^  s  CnlAg=  1 

PblSn  =  I  ZnlAg=^2 

Sn/Fc  =  3  Sn/Cn   —  s 

FcjCu  =  2  Znj  Fe   =  9 


20  RADIO-THERAPY 

The  law  relating  to  tensions  is  as  follows:  If  a  chain  be 
formed  of  several  metals  in  contact  with  one  another,  the  dif- 
ference in  potential  between  the  final  links  is  equal  to  the  sum 
of  the  potential-differences  of  all  the  links,  or  is  equal  to  the 
potential-difference  which  would  result  from  direct  contact  of 
the  final  links.  From  this  it  follows  that  the  greater  the  dis- 
tance between  the  individual  members  of  the  chain,  the  greater 
the  electro-motive  force.  The  electro-motive  force  cannot  be 
increased  by  a  repetition  of  the  same  combination.  It  can  be 
shown  by  calculation  that  in  a  closed  circuit  of  conductors  of 
the  first  group  the  electric  dissociating  power  equals  o,  that  is 
to  say,  the  tension  is  everywhere  alike;  the  electricity  is  in 
equilibrium.  Again,  a  potential-difference  results  when  met- 
als and  liquids  are  brought  into  contact.  If  the  potential-dif- 
ference between  zinc  and  copper  be  .considered  as  lOO,  ac- 
cording to  Kohlrausch,  the  following  figures  are  obtained  in 
different  combinations : 


Zinc 

Copper 
Silver 
Gold 
Platinum 


water  =  —61.6 

water  =  —  330 

water  =  — 17.0 

water  =  -33-7 

water  =  —44.7 


Liquids  do  not  obey  the  law  of  tensions.  In  contact  with 
metals  they  become  partly  positive  and  partly  negative.  They 
are  called  conductors  of  the  second  class. 

Thus,  for  example,  every  metal  in  contact  with  water 
becomes  negative,  and  that  in  a  different  degree  for  dif- 
ferent metals,  while  the  water  becomes  positive.  Water, 
therefore,  cannot  be  included  in  the  tension  series. 

Let  us  immerse  a  zinc  and  copper  plate  in  a  vessel  of 
water.  Both  metals  become  in  the  first  place  negative, 
the  water  positive.  Expressed  in  numbers,  the  tension  of 
the  zinc  is  the  half  of  — ^61.6,  that  is,  — 30.8.  This 
positive  tension  of  the  water  (+  30.8)  goes  over  to  the 
copperplate.  Now, however, the  copper  receives  through 
the  electric  separating  power  acting  on  the  water, 
the  half  of  — 33-0,  that  is,  — 16.5.     But  the  positive 


ELEMENTS  OF  ELECTRICITY  21 

tension  from  the  water  prevails  over  the  negative  of  the 
copper   ( — 16.5)    with  the  result  that  the  copper  plate 
receives   a   positive   tension,    +  30.8  —  16.5  =  +  14.3. 
On  the  other  hand,  the  positive  tension  of  the  water, 
+  16.5    (which  it  received  by  contact  with  the  copper), 
is  added  to  the  negative  tension   ( — 30.8)   of  the  zinc 
plate.      The    tension   of   the    zinc    plate    is,    therefore, 
—  30.8  +  16.5  = —  I4-3-     The  same  rule  applies  to 
all  other  metals. 
It  follows  that  when  tw^o  metals  are  immersed  in  a  liquid, 
one  of  them  becomes  negative  and  the  other  positive.       The 
metal  which  by  its  own  separating-power  becomes  more  power- 
fully negative  remains  always  negative. 

Such  a  combination  is  termed  a  galvanic  element.  The  ends 
of  the  two  metal  plates  are  called  the  poles.  The  copper  plate 
contains  the  positive,  and  the  zinc  the  negative  pole.  A  gal- 
vanic element,  the  poles  of  which  are  not  connected,  is  called 
an  "open"  one. 

The  law  that  the  two  metals  have  a  definite  potential-differ- 
ence, which  depends  only  upon  the  nature  of  the  two  metals  and 
the  liquid,  and  not  upon  their  size  and  shape  or  the  quantity 
of  the  liquid,  applies  also  to  the  galvanic  element.  This  defi- 
nite tension-difference  is  called  the  electro-motive  force  of  the 
element. 

If  the  poles  of  an  element  charged  with  a  potential-differ- 
ence are  connected  by  means  of  a  conductor,  a  current  must 
result;  electricity  always  flows  from  a  place  with  higher  poten- 
tial to  one  with  lower.  Since,  however,  the  source  of  the 
charge  (the  contacts)  remains  within  the  element,  demanding 
the  same  potential-difference  in  the  poles,  fresh  electricity  flows 
at  once  to  the  latter  and  equalises  itself  through  the  connecting 
wire.  One  sees,  therefore,  that  this  current-flow  and  equalising 
process  must  be  constantly  going  on ;  the  electricity  never  arrives 
at  a  state  of  equilibrium,  but  a  continuous  current  results.  1  his 
Is  called  a  galvanic  current.  The  source  of  the  current  is  to  be 
found  in  the  chemical  energy  which  is  spent  when  employing 
conductors  of  the  second  class;  these  latter,  as  is  well  known, 
arc  required  for  a  current-producing  clement. 


22  RADIO-THERAPY 

The  positive  electricity  flows  uninterruptedly  from  the 
higher  tension  along  the  wire  connecting  the  two  poles,  thence 
through  the  metal  and  liquid.  In  the  case  of  the  above-men- 
tioned element  positive  electricity  is  found  at  the  copper  pole. 
This  positive  electricity  flows,  therefore,  from  the  copper  pole 
along  the  connecting  wire  to  the  zinc  pole,  thence  from  the  zinc 
plate  into  the  water,  and  so  to  the  copper  plate  again.  We 
have  thus  a  closed  circuit.  Or  the  negative  electricity  may  be 
described  as  flowing  through  the  wire  to  the  copper,  thence  to 
the  water  and  zinc.  Thus  the  current  may  be  followed  for  pur- 
poses of  description  in  one  of  two  ways,  but  the  general  method 
is  to  consider  it  as  flowmg  from  the  higher  potential  to  the 
lower,  that  is,  in  the  direction  of  the  positive  current. 

We  speak  of  a  stream  of  water  flowing  from  a  higher  to  a 
lower  level,  and  in  the  same  way  an  electric  current  is  under- 
stood as  passing  along  a  conductor  from  a  point  of  higher  to 
one  of  lower  tension.  As  has  already  been  mentioned,  the 
tension-difference  between  these  two  points  constitutes  the  elec- 
tro-motive force. 

The  amount  of  water  which  passes  in  one  second  a  given 
point  in  the  course  of  a  stream  is  governed  by  the  force  of  the 
current,  and  may  be  expressed  in  litres  or  kilogrammes.  In 
the  same  way  the  quantity  of  electricity,  that  is,  the  number  of 
coulombs  passing  a  given  sectional  area  of  the  wire  in  one 
second,  is  called  the  intensity  or  strength  of  the  electric  cur- 
rent, and  is  measured  in  units  of  amperes.  The  motive  force 
of  a  stream  of  water,  or  of  water  falling  from  a  height,  cor- 
responds to  the  tension-difference  between  two  points  in  an 
electric  current,  or  its  electro-motive  force.  As  regards  work- 
capacity  a  comparison  may  also  be  drawn  between  a  current  of 
electricity  and  one  of  water. 

We  have  seen  that  a  current  of  water  results  from  its 
movement  along  an  inclined  plane  by  reason  of  gravity; 
if  there  were  no  hindrance  to  its  progress,  the  velocity  of 
the  water  would  become  greater  and  greater  in  its 
course,  being  as  great  at  any  given  point,  as  though  it 
had  fallen  directly  there  from  its  original  level.  This, 
however,  is  not  the  case  with  water-streams,  the  current 


ELEMENTS  OF  ELECTRICITY  23 

being  found  to  move  comparatively  slowly  in  certain 
places. 

This  results  from  obstruction  to  its  progress  by  fric- 
tion with  the  bed  of  the  stream.  The  work  accom- 
plished by  gravity  in  the  movement  of  the  water  ov^er  this 
obstruction  is,  of  course,  not  lost:  work,  indeed,  can 
never  be  lost.  The  energy  expended  receives  its  equiv- 
alent in  a  certain  amount  of  heat,  which,  though  hardly 
measurable,  raises  the  temperature  of  the  water  and  its 
bed. 

By  the  aid  of  water-wheels,  turbines,  and  the  like,  one 
can  transform  the  energy  of  the  falling  water  into  me- 
chanical power.      The  maximum  of  work  which  one  can 
extract  from  a  waterfall  per  second,  is  estimated  by  mul- 
tiplying the  height  of  the  fall  by  the  weight  of  water 
falling  in  that  second.      Just  as  the  effect  of  flowing 
water  is  measured  in  meter-kilogrammes,  the  product  of 
volt  and  ampere  (the  watt)   indicates  the  power  of  an 
.  electric  current  between  two  points  in  its  course.      If  be- 
tween these  two  points  there  is  an  uninterrupted  con- 
ductor,  the  heating  of  the   latter  constitutes  the  only 
work-effect  of  the  electric  current,  and  the  amount  of 
heat  thus  developed  must  be  equivalent  to  the  product  of 
volt  and  ampere. 
One  can  with  the  aid  of  liquids,  since  they  do  not  obey  the 
law  of  the  tension-series,  at  will  increase  potential-difference  of 
electro-motive  force  by  repetitions  of  the  same  combination. 

If  we  take  a  galvanic  element  in  which  the  tensions 
of  the  two  metals  differ  to  the  extent  of  i  volt,  and  earth 
the  zinc  plate,  the  tension  of  the  latter  will  become  o; 
that  of  the  copper  will  be  i  volt.  Any  conductor  joined 
with  this  copper  plate  also  participates  in  this  tension; 
this  will  apply,  moreover,  to  the  zinc  plate  of  a  second 
element  if  it  likewise  be  attached.  The  copper  plate, 
however,  of  this  second  element  must  already  possess  a 
tension,  of  i  volt  higher  than  its  zinc  fellow,  conse- 
quently it  now  possesses  a  tension  of  2  volts.  Similarly, 
the   copper   plate   of   a   third   element  connected   in   a 


24  RADIO-THERAPY 

like   manner   will    possess    a    tension    of    3    volts,    and 
so  on. 

If  one,  therefore,  in  this  way  connects  a  certain  num- 
ber {n)  of  galvanic  elements,  the  tension-difference  (the 
electro-motive  force)  will  be  greater  than  in  any  single 
element. 
A  series  of  galvanic  elements  arranged  in  the  above  manner 
by  coupling  them  together,  is  called  a  chain,  or  battery,  and  this 
particular  mode  of  connection  is  termed  serial.      The  terminals 
are  called  battery-poles. 

In  addition  to  the  galvanic  elements  described  above,  which 
contain  only  one  kind  of  liquid,  there  are  others  in  which  the 
metals  are  immersed  in  different  liquids.  In  this  case  the  liquids 
are  separated  by  a  porous  clay  diaphragm.  Of  the  two  plates 
(of  the  first  class  of  conductors) ,  one  is  invariably  made  of  zinc. 
In  strong  batteries  this  is  always  amalgamated  in  order  to  pre- 
vent corrosion  while  the  element  is  at  rest. 

The  commonest  forms  of  galvanic  elements  are  given 
as  follows,  together  with  indications  of  their  electro- 
motive force : 

1.  Daniell's  cells:  Amalgamated  zinc  in  25%  sul- 
phuric acid,  copper  in  concentrated  copper  sulphate  solu- 
tion.    Electro-motive  force  in  volts :    1.068. 

2.  Meidinger's  e\e.mtnt:  Zinc  in  solution  of  mag- 
nesium sulphate,  copper  in  concentrated  copper  sul- 
phate.   Electro-motive  force:  0.952  volt. 

3.  Biinsen's  element:  Amalgamated  zinc  in  8% 
sulphuric  acid.  Carbon  in  fuming  nitric  acid.  Electro- 
motive force:    1.88  volts. 

4.  Chromic  acid  element  (Btinsen)  :  Amal- 
gamated zinc  and  carbon  in  a  solution  of  12  parts  bi- 
chromate of  potash,  25  parts  concentrated  sulphuric 
acid,  100  parts  water.  Electro-motive  force:  2.03 
volts. 

5.  Grove:  Amalgamated  zinc  in  25%  sulphuric 
acid,  platinum  in  fuming  nitric  acid.  Electro-motive 
force:  1.93  volts. 

6.  Leclanclie:     Amalgamated  zinc  in  solution  of 


ELEMENTS  OF  ELECTRICITY  25 

sal  amoniac,  carbon  with  a  mixture  of  manganese.  Elec- 
tro-motive force:  1.48  volts. 
The  galvanic  current,  in  addition  to  mechanical,  magnetic, 
electro-dynamic,  inductive-light  and  heat  effects,  causes  chem- 
ical action.  It  if  passes  through  a  liquid,  chemical  decomposi- 
tion always  results,  the  process  obeying  well-detined  laws  {elec- 
trolysis). 

The  immersed  plate  connected  with  the  negative  pole 
of  the  battery,  is  called  the  cathode;  the  other,  con- 
nected with  the  positive  pole,  is  the  anode.  The  sub- 
stance underlying  decomposition  is  known  as  the 
electrolyte;  its  particles  separated  about  the  plate  are 
the  ions. 

If  the  galvanic  current  be  conveyed  through  dilute 
sulphuric  acid,  hydrogen  is  evolved  at  the  cathode  and 
oxygen  at  the  anode. 

Electrolysis  obeys  the  following  laws  (Faraday)  : 

1.  The  amount  of  decomposition-products  formed 
in  a  given  unit  of  time  is  proportional  to  the  intensity 
of  the  current;  that  is  to  say,  to  the  electrical  quantity 
passing  through  in  that  period. 

2.  Each  unit  of  current  at  the  electrodes  evolves 
chemically  equivalent  quantities  (that  is,  such  quantities 
as  are  capable  of  chemical  re-combination) . 

If  a  certain  electric  quantity  be  required  to  traverse 
an  electrolyte,  according  to  Faraday's  law  this  can  only 
be  accomplished  by  the  removal  of  a  definite  quantity  of 
hydrogen  from  anode  to  cathode,  thence  escaping.  This 
relation  between  the  transmission  of  electricity  and  the 
ions  leads  one  to  assume  that  the  latter  are  direct  car- 
riers of  electricity.  We  see  that  under  all  conditions, 
whatever  be  the  chemical  combination  with  which  we  are 
dealing,  positive  electricity  always  accompanies  the  hy- 
drogen ;  we  may  suppose,  therefore,  that  //  in  the  com- 
bination HSO4  has  a  greater  affinity  for  positive  elec™ 
tricity  than  SO^,  which  fulfills  the  role  of  carrier  of  nega- 
tive electricity.  One  may,  therefore,  conceive  each  atom 
of  a  combination  as  being  charged  with  a  definite  elec- 


26  RADIO-THERAPY 

trical  quantity,  base  and  acid,  indeed,  being  charged  with 
dissimilar  electricity. 

Every  hydrogen  ion  bears  a  certain  electric  quantity. 
According  to  Faraday's  second  law  of  electrolysis,  each 
current-unit  produces  chemically  equivalent  quantities  at 
the  electrodes.  Therefore,  the  chemical  value  of  each 
ion  moving  in  the  electrolyte  appears  joined  with  a  defi- 
nite and  unchangeable  quantity  of  positive  or  negative 
electricity.  Therefore,  every  single-value  ion  conveys 
just  as  much  electricity  as  an  H-ion,  while  the  two-  and 
three-value  ions  convey  double  or  triple  electrical  quan- 
tities. If  one  measures  the  current  passing  through,  and 
the  amount  of  hydrogen  evolved,  one  can  estimate  ex- 
actly how  much  electricity  falls  to  i  grm.  of  hydrogen 
or  to  I  ion.  This  quantity  is  known  as  the 
electron     (see    Introduction)  ;    it    amounts    to    about 

6  X  lo  ~  '°  =  ( rpr; — r-)  clcctrostatic  units. 

\io  milliards/ 

Water  is  decomposed  by  the  current  in  the  galvanic  ele- 
ment; hydrogen  and  oxygen  are  formed,  H  at  the  copper  and  O 
at  the  zinc. 

Experiments  show  that  such  plates  covered  with  gas 
produce  an  electro-motive  force  and  a  current  which  pro- 
ceeds in  an  opposite  direction  to  the  original  current. 
This  secondary  current  endures  till  the  decomposition 
products  are  dissipated.      Plates  which  are  covered  with 
decomposition-gases  are  described  as  polarised;  the  cur- 
rent which  they  produce  is  the  polarisation-current. 
In  a  galvanic  element  the  water  is  decomposed,  hydrogen 
going  to  the  copper  plate  and  forming  a  film  there  which  breaks 
the  current.      Galvanic  polarisation   (electro-motive  opposing- 
force)  explains  the  early  weakening  of  the  original  electro-mo- 
tive force  of  the  element,  and  its  final  reduction  to  a  minimum. 
Herein  lies  the  unrellabiHty  of  galvanic  elements.      Primary 
elements,  of  whatever  system,  all  have  the  disadvantage  of  being 
very  dear  to  work  compared  with  their  capacity,  either  requiring 
very  frequent  and  by  no  means  easy  renovation,  or  possessing 
very  little  current-power. 


ELEMENTS  OF  ELECTRICITY  27 

§  9.  Accumulators. 
Accuiniihitors,  or  "secondary  elements,"  obtain  their  effect 
by  reason  of  the  polarising  action  of  oxygen  and  hydrogen  ar- 
ranged as  ions.  In  Phinte's  accumulator  two  lead  plates  are 
Immersed  In  dilute  sulphuric  acid.  If  a  current  be  passed 
through,  oxygen  is  "separated"  at  one  plate  (the  positive) ,  lead- 
ing to  the  formation  of  peroxide  of  lead,  which  Is  seen  as  a  red- 
dish-brown deposit  on  the  plate.  Meanwhile,  the  other  plate 
(the  negative)  becomes  coated  with  sulphate  of  lead  by  the  ac- 
tion of  sulphuric  acid.  The  accumulator  Is  fully  charged  only 
when  this  latter  process  is  complete.  It  has,  through  the  Influ- 
ence of  the  electric  current,  received  chemical  energy,  a  chem- 
ical power  of  work.  The  saturation-point  of  charging  Is  marked 
by  the  evolution  of  hydrogen  and  oxygen  at  cathode  and  an- 
ode, respectively,  the  electricity  being  no  longer  able  to  Induce 
chemical  action  on  the  plates  themselves.  During  the  charg- 
ing the  sulphuric  acid  solution  becomes  more  and  more  con- 
centrated. If  the  accumulator-circuit  be  closed  a  reversed 
polarisation  current  results,  reducing  the  peroxide  to  oxide  on 
one  plate,  the  sulphate  on  the  other  plate  being  likewise  altered 
to  oxide.  When  both  plates  have  become  chemically  Identical, 
the  current  ceases.  By  repeated  charging  and  unloading  the 
plates  become  more  capable  of  the  peroxide  charge.  Plantes 
elements  had  to  be  worked  for  a  long  time  in  this  way  before 
they  could  be  made  to  retain  any  considerable  charge.  Faiire 
tried  to  remedy  this  defect  by  pressing  a  layer  of  lead  oxide 
onto  the  plates  in  the  first  Instance.  This  layer,  however,  had 
a  tendency  to  fall  from  the  plate,  a  failing  which  was  obviated 
to  some  extent  later  by  grooving  the  plate.  By  constant  use 
the  chemically  active  portion  of  the  plate  tends  to  become  porous 
and  spongy,  and  Is  easily  destroyed,  especially  when  quickly 
charged.  Moreover,  the  plate  Is  then  liable  to  get  easily  bent, 
and  both  plates  may  come  into  contact,  thereby  effecting  a 
"short-circuit."  Even  v/Ithout  such  a  contingency  the  capacity 
of  the  accumulator  is  prone  to  become  Impaired  through  the 
falling  of  masses  of  the  porous  material  to  the  floor  of  the  bat- 
tery, whereby  the  plates  may  become  bridged  across  and  a  short 
circuit  established.      The  chemical  process  does  not  penetrate 


28  RADIO-THERAPY 

very  deeply  into  the  lead  plates;  the  accumulator's  capacity, 
therefore,  depends  upon  the  size  and  number  of  these  plates 
and  their  general  formation.  An  accumulator  may,  however,  be 
charged  afresh  any  number  of  times,  and  will  be  capable  of 
evolving  each  time  a  discharge  current  which  is  distinguished 
from  that  of  the  primary  battery  by  its  height  and  constant  elec- 
tro-motive force.  The  discharge  current,  however,  never  quite 
equals  the  primary  current  in  actual  quantity. 

In  the  Tudor  accumulator  the  positive  lead  plates  are  pro- 
vided with  deep  horizontal  grooves.  The  negative  plates  are 
cross-barred  and  contain  lead-masses  in  the  grooves,  which, 
during  the  charge,  become  completely  changed  to  spongy  lead. 
The  plates  are  cast  into  shapes  with  projections  on  either  side 
fitting  into  the  vessel  holding  them.  A  series  of  positive  plates 
soldered  together  and  a  similar  series  of  negative  plates  are  now 
placed  into  a  wooden  or  glass  receptacle  containing  dilute  sul- 
phuric acid.  Contact  between  adjacent  positive  and  negative 
plates  is  prevented  by  the  insertion  of  glass  rods  between  them. 
The  vessel  is  made  deep,  so  that  a  considerable  space  is  left  be- 
tween its  bottom  and  the  lower  ends  of  the  plates;  here  any  fall- 
ing substance  has  room  to  accumulate.  The  leaden  ledges  of 
the  positive  plates  of  one  cell  have  grooves  in  which  the  negative 
plates  of  another  cell  fit,  for  just  as  one  can  couple  up  several 
galvanic  elements,  the  same  can  be  done  with  several  accumu- 
lator-cells to  form  a  battery.  These  compound-celled  accumu- 
lators are  arranged  in  wooden  cases  lined  with  lead.  The  sepa- 
rate cells  are  connected  in  series,  so  that  at  either  end  a  positive 
and  negative  pole  is  left  free  with  which  to  control  the  battery. 
Accumulators  much  used  are  those  of  Gottfried  Hagen, 
Guelcher,  Bocse,  Pollak,  and  others. 

While  accumulators  are  of  the  greatest  practical  im- 
portance, it  cannot  be  denied  that  as  yet  their  construc- 
tion is  by  no  means  perfect.  Amongst  the  many  draw- 
backs to  their  use  may  be  mentioned  their  sensitiveness  to 
shocks  and  over-exertion,  the  difficulty  of  transporting 
them,  their  rapid  loss  of  power,  frequent  failures  on  ac- 
count of  internal  derangement  in  the  shape  of  bending 
of  the  plates,  etc.,  cracking  of  glass  cells,  leakage  of  acid, 


ELEMENTS  OF  ELECTRICITY  29 

their  high  initial  cost  and  expensive  up-keep.     Many  of 
these  disadvantages  are,  it  is  claimed,  obviated  in  the 
Belirend-Dessaiier  apparatus.      This  is  formed  of  cells 
packed  with  glass  powder  and  a  hygroscopic  fibre,  the 
whole  mass  soaked  with  dilute  sulphuric  acid  and  press- 
ing the  active  spongy  portion  of  the  plates  in  position. 
Thus  any  bending  of  plates,  with  consequent  short  cir- 
cuit,  is  avoided,   likewise  falling  down  of  the  spongy 
lead. 
Each  accumulator-cell  has  an  average  tension  of  2  volts. 
The  cells  should  never  be  exhausted  beyond  a  certain  point,  or 
the  plates  will  be  impaired.     Their  limit  for  each  size  of  accu- 
mulator is  indicated  by  the  maker.       The  electrical  quantity 
given  out  during  the  period  of  discharge  (expressed  by  multiply- 
ing the  highest  possible  amount  of  discharge  by  the  number  of 
hours  in  which  the  current  is  evolved)   is  termed  the  accuvin- 
lator-power  or  capacity  in  ampere-hours.    Thus  a  battery  which 
gives  a  maximum  current  of  6  amperes  in  10  hours'  discharge 
has  a  capacity  of  60  ampere-hours.      An  accumulator  of  this 
capacity  can  also  supply  a  i  ampere  current  for  60  hours,  a  3 
ampere  current  for  20  hours,  and  so  on.     One  cannot,  how- 
ever, obtain  a  current  exceeding  6  amperes.       If  the  ampere- 
hour  capacity  of  the  accumulator  be  divided  by  the  product  of 
the  corresponding  time  of  charging  and  the  strength  of  the  pri- 
mary current,  one  obtains  its  relative  value  in  ampere-hours. 
This  usually  amounts  to  90%  or  95%. 

§  ID.  Ohm's  Law. 

The  fo?Te  or  intensity  of  an  electric  current  was  defined  on 
page  24.  Static  electricity  of  the  kind  found  in  a  Leyden  jar 
is  high  in  pressure  but  low  in  quantity,  and  we  know  that,  though 
its  discharge  is  violent  and  characterised  by  striking  phenomena 
(physiological,  light,  etc.),  these  are  but  momentary.  On  the 
other  hand,  a  galvanic  current,  though  of  lower  tension  and  less 
electro-motive  force,  is  comparatively  rich  as  regards  quantity. 
It  can  consequently  be  employed  for  lighting  purposes,  or  for 
mechanical  or  chemical  purposes.      (Compare  the  work  capacity 


30  RADIO-THERAPY 

of  a  large  quantity  of  air  or  water  under  low  pressure  with  a 
small  quantity  under  high  pressure.) 

Other  things  being  equal,  the  greater  the  electro-motive 
force,  the  greater  the  quantity  of  electricity  flowing  through  a 
given  sectional  area  of  a  conductor.  The  working  value  of  a 
quantity  of  water  depends,  as  we  have  seen,  upon  ( i )  its 
pressure,  (2)  the  strength  of  Its  current.  An  electric  current 
is  similarly  situated,  but  a  third  important  factor  must  be  added, 
the  resistance  of  the  conductor.  A  stream-current  meets  with 
obstruction  from  friction  with  its  bed;  moreover,  caeteris  pari- 
bus, a  current  flowing  in  a  wide  channel  will  be  much  more  pow- 
erful than  a  narrower  one.  In  order  to  obtain  the  same  current- 
force  in  the  narrow  that  we  have  in  the  wider  channel,  it  will  be 
necessary  to  increase  the  rapidity  of  flow  or  the  water-pressure. 
With  an  increasing  r^esistance  the  current-force  decreases. 

Ohm's  law  is  as  follows: 

The  intensity  of  an  electric  current  (/)  is  directly  propor- 
tional to  the  electro-motive  force  (£),  but  inversely  pro- 
portional to  the  resistance  (R) . 

R 
One  may  add  that  the  force  of  the  current  is  the  same 
in  all  parts  of  the  current-circuit  when  the  current  is  con- 
tinuous. 
A  conductor's  resistance  depends  largely  upon  its  composi- 
tion, that  is,  upon  its  specific  conducting  resistance  (K) .    Again, 
the  resistance  varies  directly  with  the  conductor's  length  (/)  and 
its  sectional  area  (/).      We  may,  therefore,  add  the  following 
equation : 

Heating  increases  the  resisting  power  of  metals,  but 
decreases  that  of  carbon. 
In  order  to  reduce  a  current  of  electricity  to  a  required  in- 
tensity it  is  often  necessary  to  interpose  various  resistances  in  its 
path.      These  are  known  as  '^rheostats."     Rheostats  may  be 
constructed  on  the  decade-resisting  principle,  which  measures  re- 


ELEMENTS  OF  ELECTRICITY 


31 


sistances  of  i-ioo  times  the  unit  and  more.  When,  however, 
the  object  Is  to  quickly  interpose  resistances  into  a  current-cir- 
cuit, determination  of  this  exact  capacity  being  unnecessary,  the 
so-called  ballast-resistances  are  useful.  The  form  of  those  usu- 
ally employed  for  strong  currents  is  known  as  a  crank  or  lever- 
rheostat  (Figs.  4  and  5),  where  a  series  of  German  silver, 
"nickelin"  or  "manganin"  spirals,  which  offer  great  resistance 
to  the  current,  are  fixed  and  insulated  in  a  frame.      By  means 


Fig.  4. 


Fig.  6. 


Fig.  4.— Lever-Rheostat    (from   Graetz   L.    Electricity,    Stuttgart,    Engclliorn, 

p.  91). 
Fig.  5.— Lever-Rheostat  of   Reiniger    (Gcbbcrt  and   Schall,   Erlangen). 

of  the  lever  a  greater  or  less  amount  of  these  metallic  spirals 
can  be  interposed  in  the  path  of  the  current.  With  the  lever- 
knob  to  the  extreme  left  the  current  is  interrupted;  as  it  moves 
to  the  right  a  gradually  increasing  resistance  is  established. 

Fig.  6  depicts  another  variety  of  resistance,  in  which  a  single 
spiral  of  uniform  thickness,  composed  of  German  silver  or  nick- 
elin, forms  the  resisting  medium.      By  sliding  a  "contact"  over 


32  RADIO-THERAPY 

this  in  either  direction,  the  length  of  the  resisting  path  can  be 
varied. 

§  II.  Technical  Measure-units. 

The  following  technical  measurement-units  have  been  agreed 
upon  since  1881  as  Indicating  current-strength,  conductor-resist- 
ance and  electro-motive  force  or  potential  difference : 

I.  The  current-strength  unit  is  i  ampere:  This  cor- 
responds to  a  current-intensity  capable  of  precipitating  0.00 1 1 1 8 
gramme  of  silver  in  one  second  from  an  aqueous  solution  of  sil- 
ver-nitrate. 

Measured  electro-magnetically,  the  unit  of  current- 
strength  Is  that  which,  traversing  an  arc  of  i  cm.  length 
and  I  cm.  radius,  acts  with  a  force  of  i  dyne  on  a  mag- 
net pole  (one)  situated  in  the  middle  of  the  circle  com- 
pleting the  arc.      The  "practical"  unit  of  the  current- 
strength,    I    ampere,   is   the   tenth  part   of   the   above 
(C.  G.  S.)  unit. 
The  quantity  transmitted  by  the  current,  one  on  a  time-unit 
through  a  given  sectional  area  of  conductor,  is  accepted  theoret- 
ically as  the  unit  of  current-quantity  or  electrical  quantity.    The 
"practical"  unit  Is,  therefore,  that  electrical  quantity  which,  with 
a  current  strength  of  i  ampere,  flows  through  a  sectional  area 
ol  conductor  in  one  second.      It  Is  called  an  ampere-second,  or 
I  coulomb.     (See  p.  12)   for  the  electro-static  unit  of  electrical 
quantity.) 

I  coulomb  =  I  ampere  X  i  second. 

From  this  we  derive  the  working-unit  of  an  "ampere-hour." 
The  ampere-hour  Is  that  electrical  quantity  which  traverses  a 
conductor  in  one  hour  or  3,600  seconds  with  a  current-intensity 
of  I  ampere,  An  ampere-hour,  therefore,  corresponds  to 
3,600  coulombs. 

The  capacity  or  holding-power  of  an  accumulator  Is 
usually  expressed  in  am.pere-hours.  By  this  one  un- 
derstands that  electrical  quantity  which  is  evolved  dur- 
ing the  average  discharge-period,  and  which  is  expressed 
by  the  product  of  the  greatest  force  of  current-discharge 


ELEMENTS  OF  ELECTRICITY  33 

and  the  time  in  hours  during  which  the  current  can  be 
utilised. 

2,  The  unit  of  resistance  is  possessed  by  that  conductor  in 
which  the  electro-motive  force  1  produces  the  current  i.  This 
unit  is  called  i  ohm. 

The  ohm  is  defined  as  the  resistance  of  a  column  of  mer- 
cury of  14.4521  grammes,  i  square  millimetre  cross-section  and 
1.062  m.  length,  measured  at  0°C. 

3.  By  the  unit  of  electro-motive  force  is  meant  that  elec- 
tro-motive force  which  produces  a  current  of  i  ampere  intensity 
in  a  conductor  possessing  i  ohm  resistance.  This  unit  was 
termed  "volt"  at  the  electrical  congress  held  in  Paris.  The  unit 
of  electro-motive  force  may  be  deduced  from  the  phenomena 
of  an  induced  current,  or  from  the  current's  working  capacity. 

I  volt  is,  we  may  mention,  the  electro-motive  force 
of  a  zinc-copper  element   {Latimer  Clark's  normal  ele- 
ment).     It  is  about   10%  less  than  the  electro-motive 
force  of  Daniell's  element. 
The  unit  of  current  capacity    (work  or  heat)    is  indicated 
when  the  work  is  accomplished  by  a  current  in  i  second,  as,  for 
example,  when  the  heat  equivalent  to  a  unit  of  work  is  produced 
in  a  wire.     (See  p.  42.) 

The  unit  is  given  by  a  current  i  and  a  resistance  i,  or  also  by 
the  electro-motive  force  i  producing  the  current.  The  practical 
unit  is,  therefore,  the  volt  ampere,  that  is  to  say,  the  capacity 
for  the  electro-motive  force  i  volt  when  producing  the  current 
I  ampere  in  i  second.  The  unit  of  effect  in  one  second  is  called 
I  watt.  This,  multiplied  by  the  total  working  period,  gives 
the  total  energy  involved  (or  accumulated).  One  usually  ex- 
presses this  in  watt-hours.     The  consumption  of  electrical  en- 

ergv  is  reckoned  in  watt-hours.      The  effect  of  one  watt  =  — tt- 
'^^  9.81 

kilogrammeter    per    second.       1  he    effect    of    one    horsepower 

amounts  to  75  kilogrammeters  or  736  watts. 

The  effect  of  one  watt  is,  therefore,  equal  to   --7    horse- 

^  736 

power. 


34  RADIO-THERAPY 

§  12.  Battery-Connections. 

If  we  close  the  current  circuit  of  one  or  more  elements,  two 
kinds  of  resistances  are  to  be  distinguished;  the  intenuil,  or  more- 
important  resistance  of  the  element,  and  the  external,  or  less-im- 
portant resistance.  The  latter  (Ra)  depends  upon  the  cross- 
sectional  area,  the  length  and  the  specific  conducting-capacity 
of  the  wire  joining  the  two  dissimilar  electrodes  (including,  of 
course,  the  apparatus  to  be  worked).  The  internal  resistance 
is  offered  by  the  liquid  of  the  element.  By  connecting  a  fresh 
element,  therefore,  fresh  resistance  is  unavoidably  added. 

As  we  know.  Ohm's  law  reads : 

'=R 

Since  the  total  resistance  is  made  up  from  the  external  and 
internal  resistances  this  formula  now  becomes 

E 


Ra  +  RT 
or,  substituting  for  the  letters  the  measurement  determinations, 

SI  {Ra  +  Ri) 

Experiments  with  two  vessels  of  water  provided  with  escape- 
tubes  show  that  when  these  are  at  the  same  altitude  and  the 
escape-tubes  are  in  connection  with  one  another,  the  escaping 
water  is  under  the  same  pressure  as  if  it  flowed  from  a  single 
vessel;  it  has,  however,  only  half  the  resistance  to  overcome, 
since  both  escape-tubes  are  joined  to  form  a  single  tube  of  double 
the  sectional  area.      Hence,  an  increase  in  the  intensity  of  the 

Fig.  7.  Fig.  8. 

Fig.  7. — Parallel   connection    (from   Donath   B.   Die   Einrichtung  zur  Erzeu- 

gung  der  Roentgenstrahlen,  Berlin  1899,  p.  g). 
Fig.  8. — Serial  connection   (from  Donath  B.  Die  Einrichtung  zur  Erzeugung 

der  Roentgenstrahlen,  Berlin  1899.  0.  8). 


ELEMENTS  OF  ELECTRICITY  35 

stream  results.  If,  however,  the  vessels  are  arranged  one  over 
the  other  the  resistance  will  be  doubled,  as  also  the  pressure.  The 
same  thing  applies  in  the  coupling  of  galvanic  elements.  Their 
connection  in  parallel  Fig.  7  results,  therefore,  in  an  increase  of 
current  and  quantity.  Connection  in  series,  or  tension-connec- 
tion {Fig.  S) ,  augments  the  electro-motive  force. 

From  the  above  the  following  formulae  may  be  given  for 
serial  and  parallel  connections  of  ;/  elements: 


nRi+Ra  '  Ri       ,      ' 

\-  A  a 

n 

that  is  to  say,  in  the  case  of  serial  connection  the  electro- 
motive force,  also  the  internal  battery-resistance,  equa'ls  the 
electro-motive  force  and  the  internal  resistance  of  a  single  ele- 
ment multiplied  by  the  number  of  elements  joined  together. 

On  the  other  hand,  in  the  case  of  parallel  connection  one 
obtains  a  battery  whose  total  electro-motive  force  equals  that 
of  any  one  of  the  joined  elements.  The  internal  resistance  of 
the  latter,  however,  is  correspondingly  smaller,  as  the  number 
of  elements  joined  is  increased. 

Let  us  examine  serial  connection  more  closely. 

If,  for  instance,  the  resistance  of  the  connecting-wire  be  very 
small  compared  to  the  internal  resistance  of  a  single  element,  so 
that  It  may  be  disregarded,  It  practically  follows 

I.  E 


I  = 


Ri 


One  therefore  gains  nothing  in  the  way  of  current-Intensity 
by  serial  connection.  The  total  current  is  approximately  as 
strong  as  though  one  were  dealing  with  one  element  only.  If, 
on  the  other  hand,  the  wire-resistance  be  very  great,  far  greater 
than  the  total  resistance  of  the  series,  one  obtains  practically 

Ra 

Consequently  the  current-strength  is  about  ;/  times  as  large  as  if 
one  were  using  one  element  only. 


36  RADIO-THERAPY 

Let  us  now  examine  conditions  in  the  second  case.  If  the 
wire-resistance  be  small  compared  with  the  internal  resistance 
of  the  battery,  so  that  it  may  be  disregarded,  then 

E  oi  an  element 
~~  ij  11  Ri  oi  an  element 

The  current-strength  is,  therefore,  about  //  times  greater  than 
that  of  one  element. 

If,  on  the  other  hand,  the  wire-resistance  be  very  great,  it 
follows  that 

E  of  an  element 


/  = 


Ra 


the  current  strength  in  this  case  is  practically  the  same  as  that  of 
one    element. 

One,  therefore,  gains  nothing  in  the  shape  of  current- 
strength.  We  have,  therefore,  these  two  rules :  //  we  wish  to 
obtain  the  greatest  possible  current-strength  when  dealing  with 
considerable  external  resistance  connection  in  series  is  advisable; 
on  the  other  hand,  parallel  connection  should  be  employed  when 
the  external  resistance  is  very  weak. 

§  13.  Ramification  of  Current. 

The  strength  of  current  is  not  everywhere  alike,  when  deal- 
ing with  conductors  of  a  branched  form ;  various  strengths  ob- 
tain along  the  different  branches,  being  inversely  proportional  to 
the  resistance  they  offer.  The  two  following  laws  given  by 
G.  Kirchhof  bear  on  the  questions  of  current-intensity  and  the 
individual  branch-resistances : 

1.  At  any  part  of  the  ramification  system  the  force  of  the 
current  flowing  toward  that  part  equals  the  sum  of  the  forces 
of  current  flowing  away  from  it. 

2.  In  the  case  of  a  ramification  system  forming  a  closed 
figure  the  sum  of  the  current  forces  obtaining  in  each  branch  of 
the  system  multiplied  by  the  resistances  of  the  same  equals  the 
sum  of  the  electro-motive  forces  existing  in  the  current  circuit. 

In   IVheatstone's   Bridge    (Fig.    9)    the   current   ramifies 


ELEMENTS  OF  ELECTRICITY  37 

through  two  conductors  between  which  a  cross-communication  is 
established,  so  that  four  branches,  a,  h,  c,  d,  result. 

A  current  generally  Hows  through  bridge  O,  whose  force 
and  direction  depend  upon  the  relations  between  the  four 
branch  resistances.  The  bridge-resistance  only  disappears  when 
the  following  proportion  exists: 

a:  b  =  c:  d. 

From  Ohm's  equation  it  is  seen  that  if  one  examines  the 
distribution  of  tension  on  the  conducting  wire  alone,  E  =  i  R. 
Now,  since  the  electro-motive  force  corresponds  to  the  tension- 
difference  at  the  conductor's  termi- 
nals, one  may  also  say:  The  differ- 
ence between  the  tensions  obtaining 
at  either  end  of  a  conductor  equals 
the  product  of  its  resistance  and  the 
current-force.  The  tension,  there- 
fore, at  the  end  of  a  current-con- 
ducting wire  is  smaller  than  that  at 
the  beginning,  the  tension-loss  cor- 
responding to  the  current- force  mul-  Fig.  g.—  lVhcatstonc's  Bridge. 
tiplied  by  the  resistance  of  the  wire. 

The  greater  the  resistance  of  the  wire,  the  greater  is  the  loss  of 
tension.  Hence  It  follows  that  the  tension-difference  at  the 
poles  of  a  closed  galvanic  element  is  smaller  than  the  element's 
electro-motive  force.  The  tension-loss  is  here  caused  by  the 
overcoming  of  the  internal  resistance  of  the  element;  it  cor- 
responds to  the  current-force  multiplied  by  that  internal  resist- 
ance. The  tension-difference  at  the  poles  of  a  current-producing 
apparatus  (battery  or  dynamo)  is  called  the  tension  of  the 
terminals.  (This  is  a  variable  figure,  being  thereby  distin- 
guished from  the  electro-motive  force  of  the  apparatus,  which 
remains  constant.) 

In  the  case  of  a  branch-system  in  which  the  commencements 
and  terminations  of  all  the  branches  are  severally  connected 
{''^paraUrl-coniieclion'''  of  conductors),  the  resistance  of  an  indi- 
vidual branch  is  not  equal  to  the  sum  of  the  resistances  in  all  the 
branches,  but  is  equal  to  the  resistance  which  would  be  offered 


38  RADIO-THERAPY 

by  one  conductor  whose  sectional  area  corresponded  to  the  sum 
of  sectional  areas  of  the  individual  branches. 

In  case  of  a  conductor-system  where  the  commencement  of 
one  branch  is  connected  with  the  end  of  another  the  total  resist- 
ance is,  however,  clearly  increased.  If  the  resistances  of  indi- 
vidual branches  be  indicated  by  r^,  Vn  .  .  .  .  /•„  their  total  re- 
sistances in  parallel-connection  Rp  is  shown  by  the  equation 

IT  -  r  ^  '   '   '+7"' 

■"^p  I  -         '  re 

their  total  resistance  in  serial  connection  RH  by  the  equation 

Rh  =  r,-\-r^+   .   .   .   .    +  r„. 

§  14.  Measurement  of  an  Electric  Current. 

If  an  electric  current  be  flowing  parallel  to  a  magnetic  needle, 
or  spirally  around  it,  the  needle  becomes  deflected  from  its  usual 
north  and  south  direction,  the  amount  of  deflection  varying  with 
the  intensity  of  the  current.  If  one  imagines  a  person  swimming 
in  the  direction  of  the  positive  current,  turning  his  face  mean- 
while toward  the  needle,  the  north  pole  of  the  latter  becomes  de- 
flected toward  his  left  hand.  {Ampere's  vu\t.)  This  property 
of  a  magnetic  needle  may  be  employed,  not  only  to  determine  the 
existence  of  an  electric  current,  but  also  its  direction  and  force. 
On  this  principle  galvanometers  have  been  constructed.  In 
these  the  current  passes  along  a  few  spiral  turns  of  thick  wire 
ofi^ering  but  little  resistance,  so  that  the  Instrument  influences  the 
current-intensity  of  the  circuit.  The  amount  of  deflection  then 
indicates  the  amount  of  this  current-intensity.  An  ampere- 
meter is  merely  a  galvanometer  with  the  dial  registered  in 
Ampere's  manner. 

These  instruments  are  only  suitable  for  feeble  currents.  In 
measuring  currents  of  greater  intensity,  the  amperemeter  re- 
quires adaptation  in  the  shape  of  "shunt-circuits."  These  are 
connected  to  the  terminals  of  the  amperemeter,  and  the  re- 
sistance of  each  "shunt"  corresponds  to  the  resistance  of  the 
meter  itself.    Consequently,  only  a  certain  portion  of  the  current 


ELEMENTS  OF  ELECTRICITY 


39 


actually  tiows  through  the  uistrument,  the  amount  varying  in- 
versely with  the  number  of  shunts. 

The  indicated  number  on  the  dial,  therefore,  multiplied  by 
the  number  of  shunts,  gives  the  intensity  of  the  main  current. 

By  its  inclusion  with  a  branch  or  shunt-circuit,  a  galvanome- 
ter may  also  be  used  to  indicate  tension  difference. 

An  instrument  for  this  purpose,  however,  differs  from  the 
amperemeter  in  that  a  great  resistance  is  offered  to  the  current, 
the  conducting-wire  being  thin,  and  arranged  in  a  great  number 
of   spirals.       The   amount   of   deflection   caused  by   a   current 


Fig.  10. 


Fig.   II. 


(coming  from  a  source  with  small  internal  resistance)  is  propor- 
tional to  its  electro-motive  force,  or  to  the  tension-difference  of 
the  two  points  in  the  circuit  which  are  connected  through  the 
meter.  The  dial  being  suitably  registered,  one  can  read  off 
the  amount  of  this  electro-motive  force  or  tension-difference, 
expressed  in  volts.      The  apparatus  is  called  a  voltmeter. 

Apparatus  for  measuring  electric  currents  are  also  con- 
structed by  the  aid  of  other  magnetic  properties  which  they  pos- 
sess. For  example,  in  the  amperemeter  and  voltmeter  of  the 
"Allgemeinc  I^lcctricitatsgesellschaft"  (Figs.  lo  and  ii),  the 
attraction  of  a  wire  spool,  through  which  a  current  is  flowing  on 


40 


RADIO-THERAPY 


an  iron  core,  is  utilised.  A  metal  rod,  hanging  from  a  spiral 
spring,  is  drawn  more  deeply  into  the  spool  as  the  current  in- 
creases. The  force  with  which  the  metal  rod  is  attracted  varies 
with  the  square  of  the  current-strength  and  the  square  of  the 
number  of  spiral  windings.  By  means  of  a  lever  the  movement 
of  the  metal  rod  is  transmitted  to  an  indicator  furnished  with 


Fig.  12. 


Fig.  13. 


(From  L.  Graetz  I.  c.  p.  336.) 


a  dial.  The  instrument  is  registered  in  amperes  of  volts,  accord- 
ing to  its  situation  in  the  main-current  or  branch-current.  Figs. 
12-13.  W.   IVeber's  clectrodynamcmeter  is  also  used   for 

measuring  continuous  and  alternating  currents.  The 
principle  of  this  apparatus  is  founded  on  the  electrody- 
namic  effect  which  two  conductors  have  upon  one  an- 
other, whereby  they  are  constantly  striving  to  become 
parallel,  and  the  current  in  them  to  move  in  the  same 
direction.  The  amount  of  this  electro-dynamic  force 
depends  upon  the  relative  situation  and  distance  of  the 
two  current-circuits,  also  upon  the  strength  of  the  cur- 
rents. (The  sine  of  the  angle  between  the  conductors 
is  then  proportional  to  the  square  of  the  current-force.) 
With  a  different  arrangement  in  the  winding  of  the  spool 
the  instrument  can  also  be  used  for  measuring  tension- 
differences. 


ELEMENTS  OF  ELECTRICITY  41 

Hummel's  amperemeter  and  voltmeter  are  often 
employed  for  alternating  currents.  In  these  instruments 
a  piece  of  light  iron  toil  is  arranged  so  as  to  be  capable 
of  rotating  inside  a  wire  spool,  and  in  such  a  manner 
that  the  axis  of  the  rotation  does  not  coincide  with  the 
axis  of  the  spool,  but  is  placed  eccentrically.  When  a 
current  passes  through  the  spool  the  iron  foil  revolves 
on  its  axis  until  it  reaches  a  plane  where  its  weight  is 
balanced  by  the  electro-magnetic  force.  An  indicator 
joined  to  the  foil  shows  the  current-force  on  a  dial  (or 
the  tension  in  the  case  of  a  shunt-circuit). 

It  may  be  here  noted  that  so-called  ''hot-wire  instru- 
ments" are  employed  sometimes  for  the  purpose  of 
measuring  the  intensity  and  tension  of  alternating  cur- 
rents. Their  principle  lies  in  the  fact  that  a  platino-sil- 
ver  wire  traversed  by  a  current  becomes  heated,  and 
thereby  lengthened. 

The  wire  is  connected  with  an  axis  which  re- 
volves as  the  former  alters  in  length,  thereby  actuating 
an  indicator.  The  stronger  the  current,  the  greater  the 
heating  and  lengthening  of  the  wire,  with  corresponding 
greater  movement  of  the  indicator. 

§  15.  Heat  and  Lig-ht  Effects  of  the  Galvanic  Current. 

A  current  Howing  through  a  conductor  has  to  overcome  re- 
sistance, and,  therefore,  do  work.  This  active  energy  is  partly 
transformed  into  heat.  The  law  relating  to  this  heat-forma- 
tion is  as  follows:  The  amount  of  heat  developed  in  a  given 
portion  of  a  conductor  in  a  given  time  increases  with  the  square 
of  the  current-strength,  and  directly  with  the  resistance  of  the 
conductor.       {Joule's  law.) 

A  =  RP 

To  insure  the  safety  of  electric  installations,  short 
pieces  of  leaden  wire  (fuses)  are  introduced  along  the 
conductors.  Their  thickness  is  so  gauged  that  the  wire 
melts  before  the  current  can  reach  a  dangerous  limit, 
which  might  otherwise  happen  in  case  of  short-circuiting. 


42  RADIO-THERAPY 

This  accident  of  short-circuiting  happens  when  the  cur- 
rent finds  a  shorter  path  through  contact  between  indi- 
vidual portions  of  the  circuit,  whereby  any  existing  re- 
sistances (lamps,  motors,  inductors,  etc.)  are  eliminated. 
A  short-circuit  current  has  naturally  far  greater  energy, 
and  may,  therefore,  be  very  dangerous. 
This  heat-effect  finds  an  important  application  in  electric  in- 
candescent lamps,  in  which  carbon  filaments  made  from  cellulose 
are  brought  into  a  state  of  incandescence  within  vacuum  glass 
globes.      The  lighting  power  of  an  incandescent  lamp  depends 
upon  the  current-strength  and  the  resistance  of  the  filament.  As 
a  rule,  not  merely  the  current-strength  required  for  normal  burn- 
ing of  a  lamp  is  indicated,  but  also  the  amount  of  tension-dif- 
ference at  its  terminals.      Since  the  resistance  of  the  lamp  is 
known,   the  normal  current-strength  required  follows  directly 
from  this  tension.       I'he  resistance  of  an  incandescent  lamp  is 
generally  very  high;  it  requires,  therefore,  high  tension,  but  a 
comparatively  weak  current.      Numbers  are  usually  placed  on 
the  lamp  indicating  the  necessary  volts  and  amperes.      Parallel- 
connection  of  lamps  is  the  most  effective. 

Joule's  law,  as  quoted  above,  has  the  same  bearing  upon 
the  arc-light  as  upon  the  incandescent  lamp.  Whereas,  how- 
ever, with  the  latter  we  have  an  uninterrupted  conductor 
brought  into  incandescence  by  the  current;  in  the  case  of  the 
arc-lamp  two  carbon  points  and  an  Intervening  layer  of  air  form 
the  conducting  medium,  whereby  the  carbons  and  the  air  laden 
with  carbon  particles  are  made  to  incandesce. 

If  one   Interrupts   a   powerful   galvanic   current,    a 
spark  is  produced  at  the  site  of  Interruption.      This  phe- 
nomenon is  due  to  change  of  resistance  at  this  point, 
whereby  high  electro-motive  force  Is  induced  In  the  cir- 
cuit, and  a  spark  flies  across  the  air-space  separating  the 
two  poles  of  the  conductor  where  its  continuity  Is  broken. 
(For  Induction,  see  below.) 
If  we  send  a  powerful  current  through  two  pointed  rods  of 
carbons  In  contact  with  one  another,  the  latter  become  Incan- 
descent at  the  point  of  contact  in  consequence  of  the  high  re- 
sistance   offered    there.        If,    after    Incandescence    has    been 


ELEMENTS  OF  ELECTRICITY  43 

established  in  the  points,  the  rods  are  slowly  removed 
a  short  distance,  a  light  violet  arc-light  results  {"Folia's 
arc-light"),  which  is  due  to  burning  carbon  particles 
torn  off  by  and  carried  with  the  current  from  the  positive  to 
the  negative  pole.  It  is  essential,  however,  that  the  elec- 
trodes (the  carbons)  be  first  in  contact  and  afterward  separated. 
The  air  then  conveys  the  current,  for  if  its  electro-motive  force 
and  tension  are  sufficient,  electricity  can  overcome  the  resistance 
of  a  warmed  layer  of  air;  this  is  accompanied  by  the  develop- 
ment of  such  intense  heat  that  the  carbon  points  and  the  particle- 
laden  air  intervening  become  white-hot. 

A  crater-shaped  depression  (Fig.  14)  is  found  at  the  posi- 
tive carbon,  giving  forth  a  dazzling  radi- 
ance. The  negative  carbon  becomes  gradu- 
ally pointed,  and  is  consumed  at  only  half 
the  rate  of  the  positive  (their  diameters  be- 
ing equal).  In  order  to  help  in  the  forma- 
tion of  the  crater,  the  positive  carbon  Ismade 
with  a  core  of  softer  and  better  conducting 
material.  (When  employing  rapidly  alter- 
nating currents  the  condition  and  rate  of  Fi^.  14. 

combustion  of  the  carbons  are  identical.)       .„  „     ^.. 

^        (From      F.      Korner, 

The  arc-light  is  produced  only  when  the  Lehrbuch  der  Phy- 
carbon  points  are  from  2-8  mm.  apart;  sik,  Wien  und  Leip- 
therefore,  there  must  be  some  contrivance        f'^*     ^-     D^^tic -e 

r  1      •  1  •        1-  97,  P-  389) 

for  regulatmg  this  distance. 

As  already  mentioned,  considerable  electro-motive 
force  is  requisite  for  a  Voltas  arc-light;  this  results  more 
especially  from  the  fact  that  in  the  arc-light  itself  an 
electro-motive  opposing  force  exists  of  about  40  volts 
(perhaps  resulting  from  destruction  of  the  electrodes  or 
from  electrolytic  decomposition  of  the  air),  which  must 
be  overcome  by  the  current. 

Hence  the  terminal  tension  at  the  carbon  points  must 
always  be  greater  than  40  volts.  Moreover,  the  cur- 
rent-intensity must  be  very  high,  because,  according  to 
Joide'f  law.  the  heating  of  a  conductor  is  proportional 
to  the  resistance  and  the  square  of  the  current-intensity. 


44  RADIO-THERAPY 

Naturally,  the  brightness  of  an  electric  arc-lamp  depends 
not  only  upon  the  length  of  the  arc  itself,  but  upon  the 
strength  of  the  current  traversing  the  carbons.  It  is  cus- 
tomary to  indicate  the  lighting-power  of  an  arc-lamp  by 
the  intensity  of  the  current  required  to  work  it. 
Arc-lamps   may  be  joined   either  serially    (this   is  seldom 

done),  in  parallel,  or  in  groups.       In  the  latter  event  groups 

of  serially  arranged  lamps  are  joined  in  parallel  to  the  main 

current. 

In  the  case  of  parallel  connection  of  arc-lamps,  resistances 

are  placed  in  front  of  the  lamp  circuit. 

§  i6.  Thermo-Electricity. 

We  have  seen  (p.  23)  from  the  laws  relating  to  tension- 
series  that  a  current  cannot  be  obtained  from  a  series  of  metals 
alone.  This  statement,  however,  only  holds  good  if  the  tem- 
perature of  the  whole  series  be  constant.  If  at  some  part  of 
the  metal-chain  the  temperature  be  raised  or  lowered,  a  current 
results,  which  is  known  as  a  thermo-electric  current.  This  cur- 
rent always  flows  from  the  higher-temperature  locality  to  the 
lower.  Thus,  if  at  some  point  in  the  series  (say,  where  two  ad- 
jacent metals  are  soldered  together)  the  temperature  be  low- 
ered, the  current  flows  towards  that  point.  The  electrical  ten- 
sion invoked  is  greater  (given  equal  temperature  differences) 
the  farther  the  respective  elements  of  the  series  are  situated 
from  one  another.  Becquerel  arranged  the  following  series  for 
the  production  of  a  thermo-electric  current:  Bismuth,  nickel, 
platinum,  cobalt,  silver,  lead,  copper,  zinc,  iron,  antimony.  The 
electro-motive  force  of  a  thermo-electric  series  also  depends 
largely  upon  the  temperature  difference  of  the  soldering 
places. 

Frequent  attempts  have  been  made  to  produce  stronger 
thermo-electric  currents  by  uniting  several  elements  in  the  man- 
ner of  galvanic  elements,  to  form  the  so-called  thermo-pile. 
Inasmuch  as  the  electro-motive  force  of  even  the  most  effectual 
single  combination  is  very  feeble,  many  separate  elements  re- 
quire connection  in  series  for  this  purpose.      Guelcher's  thermo- 


ELEMENTS  OF  ELECTRICITY  45 

pile  can  be  used  for  practical  purposes,  such  as  charging  accu- 
mulators. In  this  apparatus  hollow  positive  electrodes  are 
cast,  as  in  small  tubes  of  chemically-pure  nickel;  the  negative 
electrodes,  likewise  tube-shaped,  are  cast  from  an  antimony- 
alloy.  The  tubular  positive  electrodes  convey  gas,  by  which, 
through  a  small  Bunsen-flame,  each  element  receives  a  certain 
amount  of  heat.  The  small  flames  heat  a  piece  of  iron  connect- 
ing the  positive  and  negative  electrodes.  The  larger-sized  pile 
constructed  thus,  and  consisting  of  66  distinct  elements,  gives 
at  average  gas-pressure  an  absolutely  constant  electro- 
motive force  of  4  volts,  with  an  internal  resistance  of  about 
0.6552.  (The  internal  resistance  of  a  thermo-pile  is  small,  the 
elements  consisting  of  metals  only.) 

The  mechanical  ejects  of  electrical  currents  upon 
one  another,  as  shown  in  induction  effects,  effects  of  a 
current  upon  a  magnet  and  vice  versa,  were  dealt  with 
when  speaking  of  electro-dynamometers. 

§  17.  The  Magnetic  Effects  of  Electric  Currents. 

Iron  or  steel  brought  near  a  conductor  transmitting  an  elec- 
tric current  become  magnetised.  This  magnetic  effect  can  be 
intensified  by  arranging  the  conductor  in  the  form  of  a  spiral 
with  the  several  windings  on  the  same  level ;  or  as  a  solenoid, 
which  consists  of  rings  arranged  in  parallel,  one  behind  the 
other.  A  solenoid  itself'behaves  like  a  magnet.  If  hung  up 
so  as  to  be  freely  movable,  it  comes  to  rest  in  the  magnetic 
meridian,  and  shows  other  phenomena  pertaining  to  the 
magnet. 

An  electric  current  passing  through  an  insulated  wire  which 
is  arranged  spirally  round  an  iron  rod,  brings  the  latter  into 
the  magnetic  state.  Its  poles  may  be  determined  by  Ampere's 
law,  above  quoted. 

The  magnetising  force  of  such  an  electro-magnet  is  propor- 
tional to  the  current-intensity  and  number  of  spiral  windings. 
With  cessation  of  the  current  soft  iron  at  once  loses  its  mag- 
netism, whereas  steel,  under  the  same  circumstances,  remains 
magnetic. 

A  current  growing  stronger  produces  less  magnetism 


46  RADIO-THERAPY 

than  a  weaker-growing  current.  This  is  known  as 
hysteresis  of  iron. 

The  "pulling  effect"  of  a  solenoid  upon  an  iron  core  has 
been  already  mentioned  (pp.  39,  etc.) . 

The  magnetic  action  of  electrical  currents  is  turned  to  ac- 
count in  the  regulators  of  arc-lamps,  in  various  current-inter- 
rupters, and  in  electric  meters.  An  electric  meter  measures  the 
quantity  of  electric  energy  consumed.  An  electric  current  does 
work  every  second  which  is  equal  to  its  tension  (in  volts)  mul- 
tiplied by  its  quantity  (in  amperes).  The  number  of  watts 
(volt-amperes),  therefore,  stands  for  the  chemical  energy  pro- 
duced each  second  by  the  current. 

The  period  of  consumption  is  reckoned  in  hours.  If,  there- 
fore, we  multiply  the  number  of  watts  by  the  number  of  hours, 
we  get  the  total  consumption  of  energy  expressed  in  watt-hours. 
Since  the  tension  is  always  constant,  one  need  but  measure  the 
number  of  ampere-hours  (current  strength  multiplied  by  time) . 
This  number  multiplied  by  the  constant  tension  V ,  therefore, 
gives  the  number  of  watt-hours. 

Aran's  electrical  meters,  mostly  used  with  continuous-cur- 
rent installations  of  constant  tension,  consists  mainly  of  two 
clock-work  pendulums  exactly  synchronised.  A  metal  rod 
hangs  from  the  lower  end  of  one  of  the  pendulums,  and  swings 
with  it  over  a  solenoid  traversed  by  the  current  about  to  be 
measured.  The  magnetic  influence  of  the  solenoid  accelerates 
the  speed  of  its  pendulum. 

This  acceleration  can  be  compared  with  the  speed  of  the 
other  pendulum,  which  swings  free.  An  indicator  is  connected 
with  the  clock-work  of  both  pendulums  in  such  a  way  that  only 
the  difference  in  velocities  is  registered.  While  no  current  is 
passing  through  the  solenoid  the  indicator  is  motionless;  the 
moment  a  current  passes  it  shows  the  acceleration  of  the  mag- 
netised pendulum.  The  amount  of  movement  of  the  indicator 
is  thus  proportional  to  the  current-strength,  and  affords  exact 
measurement  of  the  electrical  quantity  passing  through  the  sole- 
noid. 

Where  the  tension  is  not  constant  the  amount  of  energy 
consumed  can  be  measured  by  the  watt-hoiir-meter.     This  is 


ELEMENTS  OF  ELECTRICITY  47 

similar  to  the  preceding  apparatus,  but  the  pendukim  swinging 
over  the  solenoid  is  not  provided  with  a  bar-magnet.  In  place 
of  the  latter  there  is  a  roll  of  fine  wire,  which  lies  in  a  "shunt- 
circuit"  to  the  main  current.  The  force  with  which  the  cur- 
rents in  both  circuits  act  upon  each  other  depends  upon  the 
product  of  their  current-strengths.  Since,  however,  the  strength 
of  the  current  In  the  shunt-circuit  depends  upon  the  tension  at 
the  terminals  of  this  circuit  (Its  resistance  being  Invariable),  the 
force  depends  upon  the  product  of  tension  and  current-strength, 
consequently  upon  the  watts.  The  movement  of  the  indica- 
tor by  the  pendulum  accordingly  bears  direct  relation  to  the 
product  of  the  watts  and  the  duration  of  the  current.  A  dial 
is  arranged  to  indicate  the  energy  in  hecto-watt-hours.  This 
instrument  can  also  be  employed  for  alternating  currents. 

In  Thompson's  meter  an  electro-motor  turns  an  armature- 
core  wound  in  the  form  of  a  drum.  This  actuates  a  copper 
disc  set  between  magnet  poles,  and  also  a  numerating  apparatus. 
The  turning  of  the  copper  disc  is  hindered  and  regulated  by  the 
magnet  poles  (see  Foucaiilt's  currents,  below).  The  velocity 
of  revolution  of  the  disc,  which  is  affected  by  the  current  to  be 
tested,  consequently  affords  an  indication  of  the  watts  con- 
sumed. 

§  18.  Induction. 

We  have  already  seen  that  an  electric  current  produces  mag- 
netic forces.  Now  the  reverse  holds  good  to  a  certain  extent, 
viz. :  magnetism  itself  can,  under  certain  conditions,  produce 
electricity.      {Faraday.) 

If  a  magnet  be  brought  near  a  conductor  fitted  with  a  gal- 
vanometer, or  withdrawn  from  the  same,  the  galvanometer  In- 
dex moves,  thereby  showing  that  the  conductor  Is  traversed  by  a 
current.  This  phenomenon  occurs  every  time  the  magnet  is  ap- 
proached to,  or  withdrawn  from,  a  point  directly  opposite  the 
conductor. 

If  a  steel  magnet  be  brought  near  the  Iron  core  of  an  electro- 
magnet, the  core  Itself  becomes  a  temporary  magnet.  At  the 
same  moment  an  electric  current  appears  In  the  closed  circuit  of 
the  spool.     This  current  is  only  temporary,  whereas  the  steel- 


48  RADIO-THERAPY 

magnet  keeps  the  iron  core  in  a  state  of  magnetism.  The  cur- 
rent is  only  manifested  while  the  steel  magnet  is  approaching  the 
core. 

The  electric  wave^)  thus  produced  in  a  wire  circuit  while 
magnetism  is  originating  is  called  an  induced-current,  being 
transmitted  from  the  magnet  to  the  distant  wire-circuit  (in- 
duced) . 

After  this  induced  current  wave  is  over,  a  fresh  wave  pass- 
ing in  the  converse  direction  may  be  produced  by  removing 
the  steel-magnet  from  the  iron  core  and  thereby  dissipating  the 
magnetism  of  the  latter.  This  current  is  also  very  brief,  being, 
like  the  first,  merely  an  electric  wave. 

By  alternately  originating  and  dispersing  magnetism  an 
electric  current  may  be  produced  in  a  closed  wire-circuit,  which 
continually  changes  its  direction — an  alternating  current.  Fara- 
day's discovery  may  also  be  expressed  as  follows:  If  a  conduc- 
tor interferes  with  lines  of  force,  induction  takes  place  in  it. 
Electrical  energy  is  manifested  therein.  The  electro-motive 
force  of  this  induced  current  is  greater,  the  greater  the  strength 
of  the  inducing  magnet  and  the  number  of  spiral  windings,,  and 
again,  the  quicker  the  inducing  magnet  is  approached  to  and 
withdrawn  from  the  spiral.  If  the  external  resistance  through 
which  the  Induced  current  is  meant  to  flow  be  Increased,  the  elec- 
tro-motive force  of  that  current  must  also  be  increased,  and 
therefore,  other  things  being  equal,  there  must  be  a  greater  num- 
ber of  windings.  By  thus  augmenting  the  number  of  wind- 
ings very  considerable  external  resistance  can  be  overcome.  For 
this  reason  a  secondary  spiral  Is  attached  to  "spark-inductors" 
(see  below) ,  consisting  of  very  long  and  fine  copper  wire.  The 
internal  resistance  of  the  spiral  should  probably  approach  as 
nearly  as  possible  to  that  of  the  external  resistance  of  the  cur- 
rent-circuit. 

The  induction  caused  by  a  magnet  Is  termed  " 7n a gne tic-in- 
duction." Just  as  an  electric  current  is  produced  in  a  closed 
circuit  by  the  above-mentioned  method,  so  an  induced  current 
can  be  Invoked  in  wire-spools  which  are  made  to  rotate  before 


')   The   expression   "current   wave"    signifies   the   very   brief   duration   of 
each  induced  current. 


ELEMENTS  OF  ELECTRICirY 


49 


Fig.  15. 

(From  Korncr, 
1.  c.  p.  415.) 


the  poles  of  a  magnet.  The  same  principle  underlies  all  mag- 
neto-electro machines.  Here  also  it  follows  that  the  induced 
current  must  constantly  be  changing  its  direction,  according  as  a 
spool  approaches  or  withdraws  from  a  pole,  l^hese  machines 
are,  therefore,  alternating-current  machines,  which  produce  elec- 
tricity manifesting  itself  in  individual  electric  waves,  rapidly 
succeeding  one  another,  and  continually  changing  their  direc- 
tion. 

Alternating  currents  can  only  be  transformed  into  con- 
tinuous currents  by  means  of  certain  complicated 
apparatus  {commutators).  But  a  continuous 
current  may  also  be  produced  directly  by  one 
machine;  the  principles  of  this  machine  (which 
has  an  importance  for  us  by  reason  of  its  use 
in  radio-therapy)  may  be  here  briefly  ex- 
plained. 

The  earlier  magneto-electric  machines  were 
very  imperfect,  their  magnetic  field  being  weak 
and  not  fully  utilised.  Siemens'  douhle-T -mag- 
net apparatus  (Fig.  15)  constituted  a  marked  improvement. 

A  cylinder  (armature-core)  rotates  between  two  hol- 
lowed-out  poles  of  a  horseshoe  magnet.      Spiral  wires 
are  wound  lengthwise  round  this  cylinder,  so  that  the 
windings  on  the  axis-core  lie  parallel.      When  the  arma- 
ture rotates  alternately  north  and  south  poles  arc  in- 
duced in  It,  while  alternating  currents  are  produced  In 
its  spiral  winding,  which  become  transformed  into  con- 
tinuous currents  by  a  commutator. 
The  dyuamo-elrclric  machine  of  Siemens  (1867)   remedied 
the  defect  of  rapid  loss  of  power  by  the  steel  magnet  (see  Lenz's 
law  below).       In  place  of  permament  magnets,  Siemens  em- 
ployed electro-magnets,  produced  by  causing  the  Induced  current 
itself  to  flow  round  the  iron  core.      Even  the  softest  iron  core 
possesses  traces  of  residual  magnetism  ;  hence,  during  the  first 
revolution  of  the  armature  a  current,  howe\er  feeble,  will  result. 
This  feeble  current  Is  first  conducted  round  the  electro-magnet, 
which  It  strengthens      Thereby  still  stronger  Induced  currents 
are  produced,  which  strengthen  the  magnet  anew,  and  so  on 


so 


RADIO-THERAPY 


until  the  magnet  reaches  its  saturation-point.  In  this  way  pow- 
erful currents  may  be  obtained  in  a  short  time  from  very  small 
quantities  of  magnetism  through  the  reciprocating  action  of 
magnet  and  spiral-winding. 

By  a  peculiar  shaping  and  winding-arrangement  of  the  spool 
— known  as  the  armature — a  constant  and  continuous  current 
can  be  produced  in  place  of  the  wave-like  currents  of  earlier 
machines.  Here  we  shall  briefly  consider  the  principle  of  the 
gramme-ring,  a  type  on  which  many  dynamos  are  founded.  An 
iron  ring  rotates  between  the  poles  A^  and  S  of  an  electro-mag- 
net (Fig.  i6).  The  ring  carries  a  large  number  of  wire  spools, 
two  neighbouring  spools  being  joined  with  one  another  and  a 
metal  plate  belonging  to  the  current-collector,  the  whole  being 
insulated  from  the  axis  of  rotation.  The  collector  possesses  as 
many  plates  as  there  are  spools.  When  the  iron  ring  rotates, 
poles  are  formed  in  it  in  the  neighbourhood  of  A^  and  S.    These 


Fig.  i6. 
(From   Lotheisen,   Lehrbuch   der   Physik,   p.   605.) 

poles  are  apparently  constantly  changing  their  position  in  the 
ring  because  of  its  rotation,  and  hence  moving  through  the 
spools.  Consequently  currents  are  produced  in  the  latter,  which 
in  the  case  of  spools  above  the  neutral  zone  B  D  are  moving  in 
one  direction,  while  in  the  lower  part  they  move  contrariwise. 
Two  wire  bristles  (the  brushes)  are  in  contact  with  those  col- 
lectors which  happen  to  be  in  the  neutral  line.  One  brush  re- 
ceives positive  and  the  other  negative  electricity,  both  being  at- 
tached to  conducting  wires  which  convey  this  electricity  to  the 
apparatus  requiring  it.  The  armature  has  not  the  shape  of  a 
gramme-ring  in  all  dynamos;  other  contrivances  are  employed 


ELEMENTS  OF  ELECTRICITY 


51 


^ 


^. 


^. 


(\ 

V 

\o 

\o 

/ 

a 

\ 

c\ 

f 

2 

f 

^/ 

Fig.  17. 


Instead,  so  that  one  therefore  distinguishes  ring-machines  from 
drum-machines,  and  so  on. 

Alternating  currents  which,  as  we  have  seen,  are  produced 
by  magneto-electric  machines  are  not  quite  so  useful  for  radio- 
therapeutic  purposes  as  continuous  currents.  The  electro-mo- 
tive force  of  an  alternating  current  reaches  zero  at  a  certain 
time  a  (see  F^ig.  17),  increasing  afterwards  to  the  highest  value 
A,  and  then  decreasing  again  to  zero  b.  Next  the  direction  of 
the  current  is  altered,  so  that 
electro-motive  force  and  cur- 
rent-strength become  nega- 
tive. The  electro-motive 
force  falls  to  the  highest 
negative  value  B,  afterwards 
reaching  zero  again.  By  the 
"period"  of  the  alternating 
current  we  understand  that 
time  in  which  a  wave-move- 
ment is  completed,   with   its 

concomitant  position  and  negative  electricity  (the  period  a  c) . 
This  period  has  a  positive  and  a  negative  phase;  that  is  to  say, 
it  corresponds  to  a  single  alternation  of  the  current. 

The  greatest  current-strength  is  known  as  the  ampliliide  of 
the  alternating  current.  By  phase  of  the  alternating  current 
we  understand  the  current-strength  at  a  given  time  (reckoning 
from  the  point  where  this  current-strength  is  at  zero)  divided 
by  the  amplitude.  7Vo  alternating  currents  may  be  distin- 
guished from  one  another  ( i )  by  their  average  current 
strength,  (2)  by  their  periods  (one  may  have  a  period  of  yoir 
second,  the  other  a  period  of  y^-q  second),  (3)  where  their 
periods  are  equal,  by  the  fact  that  they  do  not  attain  their  maxi- 
mum value  at  the  same  time;  or,  in  other  words,  do  not  pass 
zero  and  change  their  current-direction  simultaneously.  A  sys- 
tem of  alternating  currents  possessing  equal  periods,  but  whose 
phases  are  different,  has  Important  properties  dependent  upon 
these  very  phase-differences.  Such  alternating  currents  acting 
together  are  called  multiple-phase  enrrenls.  'i'he  rotary  eiir- 
reut  is  a  special  kind  of  multiple-phase  current. 


52  RADIO-THERAPY 

In  every  magneto-electric  and  dynamo-electric  machine  the 
electro-motive  force  depends  upon  the  strength  of  the  magnetic 
field,  the  proximity  of  the  iron-core  to  the  magnet  poles,  the 
velocity  of  rotation  of  the  anchor,  and,  finally,  upon  the  number 
of  spiral  windings  on  the  latter.  If  a  continuous  current  be  sent 
into  a  dynamo,  the  latter  begins  to  rotate.  It  is  then  called  an 
elvctro-motor. 

In  order  to  understand  the  principles  of  an  electro-motor 
one  needs  but  to  call  to  mind  the  simple  laws  of  electro-mag- 
netism; by  the  flowing  of  the  current  through  the  anchor-wind- 
ings and  the  ring-spools  magnet  poles  are  produced  in  the  iron, 
and  it  is  easily  seen  that  adjacent  poles  in  ring  and  anchor  are  of 
the  same  kind.  Magnetic  poles  of  the  same  kind  must  repel 
each  other;  the  electro-motor  begins  to  work,  turning  in  the 
opposite  direction  to  that  it  would  have  were  it  a  generating  ma- 
chine. 

The  rotation  of  the  motor  may  be  transmitted  and  utilised  in 
various  ways  by  lengthening  its  axis,  employing  eccentrics,  con- 
necting-rods, etc.  Alternating  and  rotary  current  motors  are 
of  a  very  complex  nature,  which  cannot  be  described  here. 

(The  author  here  describes  common  forms  of  con- 
tact apparatus. — Translator.) 

Electrical  currents  have  also  an  inducing  effect,  known  as 
electro-  or  volta-induction. 

If  an  electric  current  be  opened  or  closed  in  the  inducing  or 
primary  coil  of  an  induction-apparatus,  a  brief  current  (the  in- 
duced current)  is^Yoductdmthe:  secondary  coil.  When  the  pri- 
mary current  is  closed,  the  secondary  current  flows  in  an  opposite 
direction;  when,  however,  the  primary  current  is  opened,  both 
flow  in  the  same  direction. 

The  same  result  is  attained  if  one  quickly  strengthens  or 
weakens  the  intensity  of  the  primary  current  by  means  of  a  rheo- 
stat, or  if  one  rapidly  introduces  the  primary  coil. within  the 
secondary  coil  (corresponding  with  the  closing  of  the  main  cur- 
rent) and  withdraws  it  equally  rapidly  (corresponding  with  the 
opening  of  the  main  current) .  Since  the  free  electricities  which 
appear  at  the  terminals  of  the  secondary  coil  on  opening  and 
closing  the  primary  current  are  directly  opposed,  the  induction 


ELEMENTS  OF  ELECTRICITY  c,^ 

apparatus  may  be  regarded  as  an  alternating-current  machine 
which,  from  one  moment  to  another,  is  alternately  producing 
currents  of  opposite  direction. 

With  regard  to  the  strcii<rth  of  the  induced  current,  that  is  to 
say,  the  electro-motive  force  induced,  the  following  laws 
apply: 

The  electro-motive  force  of  the  induced  current  is  greater: 

1.  The  greater  the  inducing  strength,  that  is  to  say,  the 
greater  the  strength  of  the  exciting  current  in  the  primary  cir- 
cuit and  the  greater  the  number  of  windings  in  the  primary 
coil;  or,  in  the  case  of  magneto-induction,  the  greater  the 
strength  of  the  inducing  magnet.^) 

2.  The  greater  the  number  of  windings  in  the  secondary 
coil. 

3.  The  greater  the  rapidity  of  the  interruptions,  that  is  to 
say,  of  the  changes  in  the  main  current. 

4.  The  less  the  distance  between  the  secondary  coil  and  the 
inducing  body  (the  primary  coil  or  magnet) . 

The  tension  of  the  induced  current  depends  upon  the  pro- 
portion obtaining  between  the  number  of  windings  in  the  two 
coils;  the  greater  the  number  of  windings  possessed  by  the  sec- 
ondary coil  compared  with  those  of  the  primary  coil,  the  higher 
is  the  tension  of  the  induced  current.  At  the  same  time,  how- 
ever, the  strength  becomes  so  much  less,  by  reason  of  the  great 
resistance  offered  by  the  many  windings  of  thin  wire  in  the  sec- 
ondary coil,  whereby  the  current  is  weakened.  One  obtains  in- 
duced currents  of  remarkable  strength  by  introducing  bundles  of 
soft  iron-wire  within  the  primary  coil;  this  results  from  the 
magnetisation  of  the  iron  core.  We  have  then  voltaic  and  mag- 
neto-induction acting  in  co-operation.  We  may  also  explain 
the  mode  of  action  of  this  apparatus  by  assuming  that  the  cur- 
rent traversing  the  primary  coil  produces  a  magnetic  field  around 
the  common  axis  (see  p.  12),  and  that  this  magnetic  field,  when 
formed  or  dispersed,  induces  a  tension  in  the  secondary  coil,  the 
amount  of  which  depends  (apart  from  other  factors)  upon  the 
size  of  the  magnetic  field.      From  this  point  of  view  the  action 


')   See  also  the  principle  of  Dcssaucr's  ai)paratus,   described   later  on. 


54  RADIO-THERAPY 

of  the  Iron  core  may  be  readily  understood/)  The  dis- 
charge-current of  a  Ley  den  jar  likewise  produces,  as  AI  assort 
has  shown,  an  induced  current  in  a  neighbouring  wire.  This  can 
best  be  demonstrated  by  an  apparatus  constructed  by  Ries. 

Just  as  a  current  at  the  moment  of  its  make  and  break  has 
an  induction  effect  upon  an  adjacent  conductor,  it  has  a  like 
effect  upon  its  own  conductor  when  the  latter  is  composed  of  a 
number  of  spiral-windings.  This  is  known  as  self-induction, 
and  the  current  thereby  produced  is  called  the  extra-current. 
When  the  main  current  is  "closed,"  a  so-called  extra  current  of 
the  interruption  appears  in  the  spirals  of  the  conductor;  its  direc- 
tion is  opposed  to  that  of  the  main  current,  and  thereby  the  in- 
tensity of  the  latter  is  not  allowed  to  at  once  attain  its  maximum. 
With  "opening"  of  the  main-current  an  "opening-current"  is 
produced  in  the  spirals,  having  the  same  direction  as  that  of  the 
primary  current,  which  latter  it  intensifies,  causing  considerable 
augmentation  of  the  spark  at  the  site  of  interruption  (see above) . 
On  account  of  the  high  tension,  the  insulation  of  the 
wires  may  be  destroyed,  for  which  reason  powerful  cur- 
rents must  not  be  sudd*enly  interrupted. 

A  shorter  time  is  required  for  the  disappearance  of  a  current 
in  a  coil  on  "opening"  the  circuit  than  for  its  production  on 
"closing."  We  know,  however  (see  above) ,  that  a  tension  pro- 
duced by  induction  is  greater  the  quicker  the  successive  induc- 
tions follow  one  another.  Consequently,  the  induction-tension 
in  the  secondary  coil  is  greater  on  "opening"  than  on  "closing." 
(On  closing  the  circuit  only  a  small  spark  is  formed,  or  even 
none  at  all,  whereas  it  may  be  very  considerable  on  "opening.") 
With  the  help  of  special  apparatus,  which  only  permit  either 
the  "opening"  or  the  "closing"  waves  of  the  induced  coil  to  pass 
through  a  body,  it  can  be  shown  that  the  induced  current  pro- 
duced by  the  opening  of  the  primary  current  possesses  a  greater 
electro-motive  force  than  that  which  is  produced  by  closing. 
When  we  come,  however,  to  examine  the  chemical  effects  of  the 
opening  and  closing  currents  respectively,  we  find  that  the  elec- 
trical quantity  traversing  the  induced  circuit  is  in  both  cases  Iden- 


^)  B.   Walter,  Fortsch.  auf  d.   Gcb.  d.   Roentgcnstrahlcn.    Vol.   I,  p.  29. 


ELEMENTS  OF  ELECTRICITY  55 

tical.  Since,  however,  the  opening  current  is  much  briefer  than 
the  closing,  it  is  evident  that  the  intensity  of  the  former  must 
considerably  exceed  that  of  the  latter. 

In  cases  where  high  tensions  are  required  only  the  opening 
tension  in  the  secondary  coil  need  be  considered,  so  that  the  cur- 
rent-waves produced  by  the  apparatus  in  use  may  be  regarded 
as  waves  of  one  direction.  The  foregoing  explains,  moreover, 
why  electro-induction  apparatus  shows  a  certain  polarity  at  the 
terminals  of  the  secondary  coil,  in  spite  of  the  production  of 
alternating  currents,  which  polarity  manifests  itself  in  a  striking 
manner  when  the  discharge  is  effected  in  a  rarefied  atmosphere. 

1  he  self-induction  of  a  conductor  and  the  electro-motive  force 
of  its  extra-current  are  mainly  dependent  (the  alterations  of  the 
current-strength  being  equal)  unon  the  shape  of  the  conductor. 

It  follows,  therefore,  that  the  relation  which  the  electro-mo- 
tive force  of  the  extra-current  bears  to  the  speed  with  which  the 
current-strength  is  varied  in  the  coil  is  merely  dependent  upon 
the  shape  of  the  coil.  This  relation  is  known  as  the  co-efficient 
of  self-induction,  or  the  self-potential  of  the  coil.  Straight  wires 
have  but  little  self-potential.  If  one  bends  a  wire  in  the  middle, 
for  example,  so  as  to  make  it  appear  double,  the  current  in  each 
half  has  an  opposite  direction,  and  the  self-potential  in  the  wire 
is  very  small.  If  one  bends  it,  however,  in  the  form  of  a  roll,  its 
self-potential  becomes  more  considerable,  and  greater  still,  if  an 
iron  core  be  placed  within  the  spool.  Each  conductor,  therefore, 
possesses  a  definite  self-induction  co-efficient  or  self-potential,  the 
amount  of  which  depends  upon  the  shape,  dimensions  (length, 
sectional  area)  and  winding  of  the  conductlng-wlre. 

Whereas  the  tension  of  the  primary  current  may  practically 
be  regarded  as  a  factor  forcing  the  current  into  the  primary 
coil,  on  the  other  hand,  the  self-induction  co-efficient  represents 
the  magnetic  Inertia-moment  of  this  coil,  which  endeavors  to 
check  the  rapid  development  of  the  current. 

B.  fValter  proved  experimentally  that  the  tension  of  the 
secondary  closing  current  grows  in  direct  proportion  with  the 
amount  of  the  primary  tension,  and  In  almost  inverse  proportion 
with  the  amount  of  self-induction  In  the  primary  coll. 

By  Increasing  the  amount  of  self-induction  In  the  primary 


S6  RADIO-THERAPY 

coll  the  closing  tension  in  the  secondary  coil  becomes  therefore  di- 
minished, whereby,  as  we  shall  see,  the  "life"  and  scope  of  reg- 
ulation of  a  "soft"  Roentgen  tube  are  considerably  augmented. 
If  one  diminish  the  self-induction,  for  instance,  by  sending  the 
primary  current  through  fewer  windings  of  the  wire,  a  greater 
current-strength  must  be  employed  if  the  magnetic  and  inductive 
effects  are  not  to  be  impaired.  I.enz  lays  down  the  following 
law  relating  to  the  direction  of  induced  currents:  In  all  cases 
of  electro-magnetic  induction  the  induced  currents  have  such  a 
direction  that  their  counter-effect  strives  to  hinder  the  process  of 
their  development. 

Induced  currents  are  met  with  not  only  in  linear  conductors 
but  in  massive  metallic  bodies;  these  are  called  Foiicault's  or 
whirl-currents.  According  to  Lenz's  law,  the  direction  of  these 
induced-currents  is  such  that  they  counteract  the  activity  of  the 
conductor-mass.  The  opposing  currents  produced  in  this  way 
in  the  massive  core  of  an  electro-magnet  on  closing  the  current 
thereby  hinder  the  development  of  the  magnetism;  in  like  man- 
ner, on  opening  the  current,  induced  currents  are  produced  in 
the  iron  mass  of  the  core,  which  have  the  same  direction  as  the 
vanishing  current,  and  delay  the  disappearance  of  the  magnetism. 
Foucattlt's  currents,  consequently,  account  for  a  considerable  and 
useless  consumption  of  energy;  they  are,  moreover,  troublesome 
by  being  transformed  Into  Injurious  heat-effects  (see  Joule's 
law) .  One  tries  to  remedy  this  defect  as  far  as  possible  by  suit- 
able distribution  and  arrangement  of  the  metal-masses.  Thus 
the  Iron-cores  of  electro-magnets  are  not  arranged  as  one  solid 
mass,  but  In  bundles  of  thin  Insulated  iron-wires  or  plates.  In 
these  no  very  pronounced  Induced-currents  can  arise,  since  they 
are  confined  to  interrupted  conductors.  For  the  same  reasons 
the  coverings  of  the  Iron-wires  are  not  made  of  metal,  but  of  an 
Insulating  material,  such  as  ebonite. 

§  19.  Spark  Induction  Apparatus. 

For  present  purposes,  perhaps  the  most  interesting  applica- 
tion of  electro-magnetic  induction  is  to  be  found  In  spark-Induc- 
ing apparatus.  By  their  means  we  may  produce  all  those  phe- 
nomena for  which  high-tension  electricity  Is  required.    The  main 


ELEMENTS  OF  ELECTRICITY 


57 


object  of  the  apparatus  is,  therefore,  to  transform  currents  of 
low  tension  to  others  of  high  tension.  Riilimkorfs  coil  {V\g. 
1 8)  consists  of  a  primary  thick-wire  coil  P,  the  core  of  which 
is  filled  with  a  bundle  of  thin  iron  wires  M  insulated  from  one 
another,  and  of  a  secondary  coil  of  thin  wire  iS  arranged  outside 
the  primary  coil,  and  having  a  very  great  number  of  windings. 


Fig.  i8. 


In  order  to  produce  rapidly-succeeding  induced  currents  in  the 
secondary  coil  the  primary  coil  current  has  to  be  opened  and 
closed  with  corresponding  rapidity;  this  is  done  by  means  of  an 
interrupter  ("rheotome") .  Interrupters  are  of  various  types,  and 
will  be  referred  to  later.  The  efficacy  of  the  whole  apparatus 
is  greatly  increased  by  means  of  the  condenser  K  (Fizeau's  con- 
denser), which  is  connected  with  the  primary  coil,      l^his  con- 


58  RADIO-THERAPY 

sists  of  a  series  of  superimposed  sheets  of  tin-foil,  insulated  from 
each  other  by  sheets  of  paper  which  are  larger  than  the  tin-foils 
and  are  impregnated  with  resin.      Sheets  of  oiled  silk  are  often 
used  instead  of  paper.      The  tin-foils  are  so  arranged  that  the 
first,  third  and  fifth  sheets,  and  so  on,  are  in  connection  with 
one  another  and  overlap  the  paper  sheets  on  one  side,  the  sec- 
ond, fourth,  sixth,  etc.,  overlapping  on  the  other,  and  being  like- 
wise in  connection.    In  the  case  of  large  induction  coils  the  layers 
of  the  condenser  sometimes  reach  the  size  of  20  qm.      These 
layers  are   in  connection  with  those  parts  of  the   interrupter 
where  the  make-and-break  occurs.     The  effect  of  this  is  to  make 
the  spark  at  the  site  of  interruption  (created  by  the  extra  cur- 
rent in  the  primary  coil)   smaller.      "Extra-current"  electricity 
passes  into  the  condenser,  positive  towards  one  layer  and  negative 
towards  another.     These  opposite  electricities  immediately  re- 
unite through  the  medium  of  the  primary  coil,  the  battery,  and 
the  current-circuit  which  connects  the  two  layers.       Hence  a 
current  arises  which  is  in  opposition  to  that  of  the  battery, 
whereby  a  momentary  "demagnetising"  of  the  iron  core  results 
and  the  induced  current  is  made  of  shorter  duration.      Thus  the 
condenser  allows  the  interruptions  to  take  place  with  greater 
rapidity,  with  the  effect  of  increasing  the  tension  in  the  secondary 
circuit  and  the  spark-length.     Whereas  without  a  condenser  the 
sparking  Is  very  pronounced  at  the  interrupter,  by  introducing 
this  appliance  into  the  primary  circuit  the  interruption-spark  is 
made  very  much  weaker.      A  condenser's  value  does  not  alone 
depend  upon  its  size:  it  requires  to  be  "tuned,"  as  it  were,  to 
the  primary  coil,  to  which  It  must  bear  a  definite  proportion. 
Experiments  by  T.  Mizuno  ^)   (Tokio)  have  shown 
that  the  capacity  of  the  condenser  has  a  great  influence 
on  the  spark-length,  and  that  by  exceeding  a  certain  ca- 
pacity the  spark  becomes  shorter  again.      Mizuno  men- 
tions a  series  of  experiments  showing  that  the  spark- 
length  increases  with  the  strength  of  the  primary  current, 
and  that  a  definite  condenser-capacity  goes  best  with  a 
given  current-strength. 


')  Phil.  Magazine. 


ELEMENTS  OF  ELECTRICITY  59 

It  is,  therefore,  advisable  to  have  an  apparatus  whose 
capacity  can  be  regulated  by  means  of  certain  contriv- 
ances. Such  an  apparatus  has  been  constructed  by  Radi- 
guet. 

According  to  JVertheim  Salamonsen  (Fortschr.,  Vol. 
IV.,  No.  3),  the  introduction  of  a  small  resistance  in  the 
condenser's  circuit  has  a  powerful  effect  in  diminishing 
the  "vibrations"  which  arise  at  the  moment  of  interrup- 
tion, by  leaving  the  so-called  lime-constant'^)   of  the  in- 
ducing current.      These  vibrations  cause  a  considerable 
potential-difference  at  the  two  ends  of  the  current-circuit 
at  the  interrupter,  which  is  equalised  by  the  spark.      By 
using  Salamonsen^ s  apparatus  one  is  consequently  able  to 
avoid  those  disturbing  explosions  which  are  apt  to  occur 
when  using  mercury  interrupters. 
Coils  fitted  with  electrolytic  interrupters   {IVehnelt's  inter- 
rupter, see  below)  are  not  worked  with  a  condenser.     The  self- 
induction  of  the  primary  coil    (which  is  negatived  by  a  con- 
denser) is  an  important  adjunct  in  interrupters  of  this  type. 

A  Riilimkorjf's  coil  possesses  yet  another  contrivance  (Fig. 
iS,  S  Jf)  by  means  of  which  it  is  not  only  possible  to  rapidly 
interrupt  the  current  passing  through  the  primary  coil,  but  also 
to  change  its  direction  at  any  time  and,  therefore,  alter  the  poles 
of  the  induced  circuit.  The  apparatus  consists  of  a  cylinder  of 
ivory,  vulcanite,  or  wood  (Fig.  19)  resting  on  a  couple  of  piv^ots 
insulated  from  each  other.  The  cylinder  can  be  turned  by 
means  of  a  handle  between  two  copper  beds.  To  the  latter 
screws  are  connected,  which  receive  the  ends  of  the  primary  {a) 
coil-wire  [b) .  A  couple  of  small  metal-plates  are  screwed 
fast  to  the  cylinder — one  screw  joins  the  right-hand  plate  with 
the  upper  piv^ot,  another  the  left-hand  plate  with  the  lower 
pivot.  Springs  slide  over  both  plates,  and  each  spring  is  in 
connection  with  a  pole  of  the  electrical  source.     The  drawing 


2 1 

')   Time  constint  =  — ^    ^^^  =  self-induction   co-efficient;/?  =i  resistance). 

'  '       '<  ,,  .         . 

It    determines    the   amplitude    of    the    vibrations:    (i  =  Ac — — -  sin /i -f)    in 
single  periods. 


6o 


RADIO-THERAPY 


shows  the  course  of  the  current  for  one  position  of  the  commu- 
tator. On  rotating  the  cyhnder  through  i8o°  the  current  is 
reversed;  at  go"*  the  springs  no  longer 
shde  on  the  metal  plates  of  the  cylinder, 
but  on  its  wooden  non-conducting  portion, 
whereby  the  current  is  interrupted. 

Another  frequently  used  form  of  dis- 
connector consists  of  a  flat  piece  of  metal 
fastened  to  a  wing-shaped  horizontally  ro- 
tating handle.  As  the  handle  turns  the 
wings  come  into  connection  with  two  flat 
springs  which  are  in  connection  with  the 
conductors.  Thus  the  circuit  can  be  made 
or  broken. 

The  primary  coil  consists,  as  before 
mentioned,  of  thick  wire  of  shorter  length 
than  that  of  the  secondary  coil.  This 
wire  is  wound  on  a  hollow  cylinder  of  wood  or  papier-mache. 
The  cylinder  is  filled  with  a  bundle  of  thin  soft-iron  wires,  each 
wire  being  separately  varnished.  The  cores  of  modern  coils 
(those,  for  instance,  of  the  Allgemeine  Elektricitats-Gesell- 
schaft,  Berlin)  are  made  of  layers  of  iron  plates.  Besides 
great  magnetic  conducting  capacity  an  almost  perfect  freedom 
of  "whirl-current"  is  thereby  obtained,  so  that  losses  of  energy 
in  the  iron  are  practically  obviated. 

We  have  already  seen  (p.  58)  that  self-induction  plays  an 
important  part  in  the  working  of  a  coil  with  JVehnelt's  inter- 
rupter, and  that  this  applies  more  especially  when  working 
the  apparatus  in  conjunction  with  a  Roentgen-ray  tube.  It 
follows  that  in  order  to  be  able  to  properly  regulate  and  in- 
crease the  life  of  a  vacuum  tube  we  require  some  method  for 
increasing  the  self-induction  of  the  primary  coil.  For  these 
cases  in  which  it  is  required  to  weaken  the  eftect  of  an  inductor 
worked  with  PFehnelt's  interrupter  B.  fValter  recommends  the 
following  proceeding^)  :  On  a  thick  roll  of  cardboard  3  cm. 
in  diameter  about  150  turns  of  copper  wire  f  mm.  thick,  and 


^)   Fortschr.  a.  d.  G.  d.  Roentgenstr.,  Vol.  II,  p.  225. 


ELEMENTS  OF  ELECTRICITY 


6i 


duly  Insulated,  are  wound.  This  "inductive"  resistance  is  in- 
troduced behind  the  ordinary  regulating  resistance  into  the 
primary  current-circuit.  If  the  former  resistance  be  not  suffi- 
cient of  itself  to  weaken  the  eftect  of  the  coil  on  the  tube,  some 
of  the  latter  resistance  (the  main  resistance)  may  be  used  with 
the  same  object.  If,  however,  the  interruptions  in  the  IVehnelt 
vessel  are  even  then  irregular,  we  may  increase  the  self-induc- 
tion by  putting  a  suitable  number  of  iron  wires  about  i  mm. 
thick  and  1^  cm.  long  into  the  cardboard  roll.  This  per- 
mits a  considerable  augmentation  of  the  ordinary  regulating 
resistance. 

With  an  ordinary  resistance  placed  in  front  of  the  in- 
ductors used  with  U'ehuelt's  interrupter  one  cannot  obtain  a 
weakening  of  their  effect.  The  explanation  of  this  lies  in  the 
fact  that  self-induction  (dependent  on  the  number  of  windings 
in  the  primary  coil  and  the  size  of  its  iron  core)  is  now  much 
smaller  than  in  the  former  apparatus,  so  that  by  simple  weaken- 
ing of  the  current  with  an  ordinary  resistance  the  "primary 
opening  tension"  originating  on  interrupting  the  current  is  no 


Fig.  20. — Spark-inductor   with    primary    coil    for    variable    self-induction,    by 
Max  Kohl,  Chcmnit.-?. 

longer  strong  enough  to  produce  a  sufficient  quantity  of  gas,  or 
a   strong   enough   explosion   of   the   latter   at   the   anode   of   a 


62 


RADIO-THERAPY 


JFehnelt's  interrupter — two  conditions  upon  which  the  inter- 
rupter of  the  primary  current  largely  depends.  In  order  to 
weaken  the  induction-effect,  we  may,  however,  augment  the  self- 
induction  in  the  current-circuit.  This  is  accomplished  by  the 
simple  method  of  JValte?-  already  mentioned. 

Walter  constructed  for  the  same  purpose  primary  coils  with 


Fig.  21. 

variable  self-induction,  which  adapt  the  capacity  of  the  inductor 
to  the  vacuum  of  the  Roentgen  tube.  This  he  effected  by  ar- 
ranging the  windings  of  the  primary  coil  in  several  divisions, 
allowing  the  current  to  flow  through  one,  two,  or  more  of  these 
divisions  by  means  of  a  suitable  switch  (Fig.  20).  The  indi- 
vidual coil-windings  can  be  connected  serially,  in  two  groups, 
or  in  parallel.  The  ends  of  the  wire  windings  terminate  in 
"contacts"  at  one  side  of  the  primary  coil  (Fig.  21).  At  these 
"contacts"  pins  are  arranged  on  which  plugs  fit,  according  to 
the  connection   desired  between  the  terminals  of  the  several 


Fig.  22. 


coil-windings  (Fig.  22).  By  connecting  the  windings  serially 
(for  soft  tubes)  the  self-induction  of  the  primary  coil  is  con- 
siderably increased;  by  connection  in  two  groups  (for  tubes  of 
medium  density),  or  in  parallel  (for  hard  tubes),  the  self- 
induction  becomes,  On  the  other  hand,  diminished. 

The  primary  coil  is  covered  with  an   insulating  layer  of 


ELEMENTS  OF  ELECTRICITY  63 

glass,  ebonite,  gutta-percha  or  paraffin.  Many  makers  con- 
struct the  primary  coil  in  such  a  manner  that  it  forms  a  separate 
and  independent  part  of  the  apparatus,  so  that  it  is  introduced 
when  required  within  the  secondary  coil,  and  may  be  exchanged 
for  another  at  any  time.  In  other  kinds  of  apparatus  the 
secondary  coil  is  wound  directly  on  the  primary.  The  former 
consists  of  a  very  thin  and  long  copper  wire,  which  is  every- 
where uniformly  insulated.  The  diameter  of  the  wire  varies 
in  different  apparatus  from  \  to  ^V  mm.  Its  length  is 
considerable,  reaching  many  kilometers  in  the  larger  models. 
By  increasing  the  length  of  wire  one  gets  a  greater  potential- 
difference;  by  increasing  its  diameter  one  gains  in  electrical 
quantity. 

One  of  the  greatest  difficulties  met  with  in  the  construction 
of  coils  lies  in  the  proper  insulation  of  the  secondary  circuit,  the 
least  defect  in  this  respect  leading  to  discharges  within  the 
apparatus  which  in  a  short  time  fuse  the  wire  and  render  the 
apparatus  worthless.  The  several  layers  of  wire,  which  is  al- 
ready of  itself  well  Insulated,  are,  therefore,  insulated  from 
one  another.  This  is  done  by  embedding  them  in  paraffin,  or 
each  layer  may  be  varnished  or  covered  with  wax  or  silk;  or 
again,  a  sheet  of  waxed  paper  or  gutta-percha  may  be  arranged 
between  the  layers.  Even  with  these  precautions  it  may  be 
very  difficult  to  induce  a  current  with  safety  through  so  long 
a  wire,  so  that  with  the  larger-sized  coils  the  plan  recommended 
by  Po^<rendorff  is  adopted.  In  this  method  the  secondary  coil 
is  built  up  of  several  short  coils,  separated  from  one  another 
by  insulating  plates,  but  with  their  wire-ends  in  contact  (see 
Fig.  18).  The  insulation  is  thereby  much  improved,  and  in 
case  of  short-circuiting  repairs  are  much  more  readily  executed, 

M.  Levy  has  constructed  coils  in  which  the  gutta-percha  in- 
sulation can  be  readily  removed  and  replaced  when  showing 
signs  of  deterioration,  which  this  kind  of  material  is  apt  after 
a  time  to  do. 

F.  Dessaiier's  apparatus  gives  a  secondary  current  which 
is  very  strong,  but  of  relatively  low  tension.  This  is  arrived 
at  by  diminishing  the  resistance  in  the  secondary  circuit.  Ac- 
cording to  Dcssauer,  the  large  coils  used  for  Roentgen-ray  work 


64  RADIO-THERAPY 

(whose  secondary  coils  are  made  up  of  an  enormous  number  of 
windings  of  exceedingly  thin  wire)  supply  a  current  of  very 
high  tension;  but  this  on  the  other  hand  has  to  overcome  a 
tremendous  resistance  in  the  coil.  This  is  not  an  ordinary  re- 
sistance, but  a  so-called  "impeding-resistance,"  for  the  current 
traversing  the  secondary  coil  is  not  a  regular  but  rather  a 
rapidly  pulsating  current,  whose  intensity  increases  to  a  maxi- 
mum and  then  decreases  with  each  pulsation.  The  resistance 
increases  with  the  length  of  the  wire  in  far  greater  ratio  than 
the  tension  with  the  number  of  windings.  By  shortening  the 
wire  in  the  secondary  coil,  therefore,  Dessauer  obtains  a  lessen- 
ing of  the  resistance,  and  consequently  an  increase  in  the  cur- 
rent-intensity of  the  secondary  circuit. 

The  ends  of  the  wire  in  the  secondary  coil  are  in  connection 
with  two  perforated  terminal  screws.  One  of  the  latter  bears 
a  rod  with  a  metal  point,  the  other  a  rod  with  a  metal  disc. 

The    tension-difference    of    the 

^      I  -t         8      m        terminals    determines    the    dis- 

I  I  tance  which  the   disc  shall  be 

I.  placed  from  the  point  in  order 

— 1 — — V- — «3        that  a  spark  may  jump   from 
^  '  one  to  the  other.     The  spark- 

FiG.  23.  ing-distance    of    a    coil    is    the 

greatest  distance  which  a  spark 
will  jump  from  one  terminal  to  another.  The  sparking-distance 
is  often,  though  not  quite  correctly,  taken  as  a  measure  of  the 
capacity  of  the  coil. 

If  one  examines  the  course  of  a  spark  in*the  spark-gap  be- 
tween the  terminals  (see  Fig.  23),  one  sees  that  with  the  cur- 
rent flowing  in  one  direction  the  spark  jumps  between  the  point 
and  the  edge  of  the  disc  a;  with  the  current  reversed  the  jump- 
ing is  from  the  point  to  the  centre  of  the  disc.  In  the  first 
instance  the  point  is  known  as  the  cathode,  the  disc  as  the  an- 
ode; in  the  second  vice  versa. 

§  20.  Current  Interrupters. 

The  capacity  of  an  induction-apparatus  depends  very  large- 
ly upon  the  manner  in  which  the  interruptions  occur  in  the  pri- 


ELEMENTS  OF  ELECTRICITY  6s 

mary  current.  The  interrupter  must  be  capable  of  giving  a 
great  number  of  interruptions,  and  the  latter  must  take  place 
suddenK,  completely  and  equally.  Interruptions  can  be  etiected 
in  a  primitive  manner  by  hand  with  a  tile,  or  a  toothed  wheel 
the  points  of  which  are  made  to  close  the  current. 

Generally,  however,  automatic  interrupters  are  used,  by 
which  the  process  can  be  more  effectively  carried  on.  The 
simplest  appliance  of  this  kind  is  to  be  found  in  Nci'f's  licim- 
mer,  which  can  be  readily  understood  from  Fig.  i8.  It  con- 
sists of  a  spring  provided  with  an  iron  piece  E  (the  hammer) 
placed  opposite  the  iron  core  of  the  coil.  This  spring  is  con- 
nected with  one  of  the  battery  poles  through  the  wire  of  the 
primary  coil.  The  wire  from  the  other  battery  pole  is  con- 
nected with  the  platinum  screw^  ScJi,  which  can  come  into  con- 
tact with  the  spring  supporting  E.  When  the  current  circuhites 
through  the  primary  coil  it  makes  the  iron  core  magnetic,  so 
that  the  hammer  E  becomes  attracted.  As  a  result  of  this  the 
current  becomes  broken,  the  iron  core  is  demagnetised,  the  ham- 
mer springs  back  into  contact  with  the  platinum  screw,  and  a 
fresh  current  is  established.  The  whole  process  is  then  re- 
peated, and  in  this  way  makings  and  breakings  oi  the  current 
rapidly  succeed  each  other.  The  number  ot  interruptions  in 
a  time-unit  depends  upon  the  length  and  tension  of  the  spring 
and  the  size  of  the  armature-core.  7'he  same  principle  under- 
lies Di'prez's,  Erneckcs,  the  J llvtnnciiw  Elckhic'ilcits-GcscU- 
schaft's,  Max  Levy's  and  other  interrupters. 

F.  Dessaiier'^)  arranges  contact  plates  (Fig.  24)  on 
both  sides  of  the  middle  of  the  spring,  and  opposite  these  two 
contact  screws  K^  K-  are  placed.  With  IC  touching  P'  the 
current  is  closed;  the  magnetised  core  then  attracts  the  spring, 
A'^  is  released  and  the  current  broken.  By  swinging  forward 
the  contact-plate  P-  strikes  the  screw  K-  and  the  current  is  again 
established.  Now  the  magnetised  core  endeaAours  to  keep  the 
spring  in  this  position,  but  this  force  is  met  by  the  inherent 
elasticity  of  the  spring.  Since  the  magnetism  can  only  act 
upon  the  length  of  the  spring  (from  />  to  the  armature  core). 


')    Fort^chr.  a.  d.  G.  d.  Roentge'iistralili  n,  Vol.   II.   II     i,  !>.   155- 


66 


RADIO-THERAPY 


whereas  elasticity  obtains  throughout  its  whole  length,  the  lat- 
ter prevails,  and  the  spring  moves  away  from  the  core.  By  this 
arrangement  Dessaners  break  gives  double  the  number  of  in- 
terruptions compared 
with  Neef's  apparatus. 
It  gives,  moreover,  a 
much  longer  period  of 
contact,  and,  conse- 
quently, more  power- 
ful induction  effects 
(Fig.   25). 


HHHh 


Fig.  24. 


Fj(..  25. 


Fig.  24. — F.  IJcssaucr's  platinum-interrupter. 

Fig.  25. — F.   Dcssaucr's   platinum-break,    Aschaffenburg. 

All  platinum-interrupters  have  one  defect  in  common :  they 
are  liable  to  be  soon  destroyed,  the  surfaces  in  contact  being 
burned  away.  Moreover,  the  spring  often  "sticks."  The  ra- 
pidity of  interruptions  again  is  small  in  proportion  to  what  is 
attained  with  more  modern  apparatus.  This  rapidity,  never- 
theless, must  not  be  too  great,  otherwise  the  extra  current 
formed  at  each  closing  of  the  inducing  current  cannot  properly 
escape,  and  the  core  of  the  coil  cannot  be  fully  magnetised,  in 
consequence  of  which  the  induced  current  does  not  reach  its 
maximum  of  intensity.  Spring-interrupters  have  the  advan- 
tage of  cheapness  and  simplicity,  and  may  be  useful  in  dealing 
with  less  powerful  primary  currents  and  smaller  coils. 

Foiicaiilt  invented  a  mercury-interrupter  for  working  large 
coils.     The  main  principle  of  this  apparatus  consists  in  closing 


ELEMENTS  OF  ELECTRICITY 


67 


the  current  by  means  of  a  metal  rod  dipping  into  a  vessel  of 
mercury.  In  order  to  eftect  a  sudden  interruption,  avoiding 
at  the  same  time  the  formation  of  an  extra-current  spark  in  the 
air  and  the  production  of  mercury-fumes,  the  mercury  is  cov- 
ered with  a  layer  of  water,  or  a  mixture  of  water  and  alcohol. 
By  allowing  the  interruption  to  occur  in  li(]uids  of  low  con- 
ducting power,  instead  of  in  the  air,  we  are  able  to  obtain  a  more 
rapid  series  of  interruptions  in  the  primary  current,  also  a  more 
rapid  escape  of  the  "opening"  induced  current,  whereby  the 
latter  gains  in  intensity.  Again,  with  the  air-spark  at  the  site 
of  interruption  we  hnve  connection  maintained  for  several  mo- 
ments between  the  separated  portions  of  the  interrupter;  this 
fav^ours  the  strengthening  of  the  opening-spark  by  the  extra- 
current.  When  employing  a  badly  conducting  liquid  as  the 
medium  the  formation  of  the  opening-spark  is  prevented, 
whereby  the  circuit  is  more  rapidly  broken. 

Fig.  26  shows  on  the  right  the  simplest  form  of  mercury- 
hammer-interrupter  (on  the  left  is  a  Neefs  liammcr) .  The 
illustration  clearly  shows  its  mode  of  action.       In  smaller  coils 


Fig.  26. — Spark-coil    with   Nccf's   liamiiicr   and    nuToury  imeniipter.    1)\    .l/o.v 
Kolil.  Clicmnitz. 


the  contact-pin  is  attracted  directly  by  the  iron  core.  Tn  the 
case  of  larger  apparatus,  however,  the  interrupter  acts  inde- 
pendently, having  its  own  electro-magnet  and  special  electrical 


68 


RADIO-THERAPY 


supply.  In  order  to  be  able  to  regulate  the  rapidity  of  inter- 
ruption, the  lever,  which  carries  on  one  hand  the  contact-pin, 
and  on  the  other  the  anchor  for  the  magnet,  is  provided  with 
a  vertical  rod  along  which  a  movable  weight  glides.  By  rais- 
ing or  lowering  this  weight  the  movement  of  the  lever  can  be 
varied. 

Interrupters  of  this  kind  have  two  mercury  vessels  with 
ascending  and  descending  contact-pins.     At  one  of  these  the 

C 


Fig.  27. — Foucatilt's  interrupter.     (From  /.    Wallcnfin.  Die  Generationen  der 
Spannungselektricitat,   Wien,    Leipzig,    Budapest   bei    Hartleben,   p.   223.) 

interruption  occurs  of  the  special  current  intended  for  the  elec- 
tro-magnet of  the  interrupter.  At  the  other,  at  the  same  time, 
the  current  traversing  the  primary  coil  is  alternately  opened 
and  closed  (  Pig.  27) . 

Fo/icdiilt's  interrupter  cannot  work  above  a  certain  speed. 
It  is,  however,  desirable  for  many  purposes  to  have  a  greater 
range  of  current-alterations  within  the  time-unit  at  one's  dis- 
posal. This  requirement  is  met  by  the  recently-constructed 
mercury-motor,  turbine  and  electrolytic  interrupters. 


ELEMEM'S  OF  ELECTRICITY 


69 


In  the  lirst,  small  rapidly-moving  motors  are  employed, 
worked  by  a  special  current.  A  \ertical  movement  is  obtained 
from  the  rotation  of  the  motor  (by  means  of  a  small  eccentric 


Fig.  28. — Lud-a'ig  Scliulmcistcr's  intcriui)ter,  Vienna. 


or  a  crank-pivot  and  connecting-rod)  and  transmitted  to  a  sil- 
vered rod  dipping  into  a  vessel  of  mercury  which  can  be  raised 
or  lowered.  With  the  rod  immersed  in  the  mercury  the  cur- 
rent through  the  primary  coil  is  closed;  with  the  rod  raised 
from  the  vessel  the  current  is  opened.  By  means  of  a  regu- 
lating resistance  the  rapidity  of  the  interruptions  may  be  varied 


Fig.  29.— Turbine-merctiry-break  by   Boas    (Mlg.   Flck.   Gcscll.,    Berlin). 

through  a  wide  range.  l"hc  mercury  is  covered  with  a  layer 
of  alcohol,  petroleum,  or  pure  water.  Fig.  2S  shows  the  de- 
sign  of  an   interrupter  made   by   /..   Sihiihiicislfr,   of  Vienna. 


70 


RADIO-THERAPY 


IJke  the  coil  to  which  it  belongs,  this  is  worked  by  a  branch 
from  the  main  (street-current,  when  this  is  continuous),  con- 
suming but  little  electricity,  is  comparatively  noiseless,  and  is 
of  very  simple  construction.  Consequently  it  can  readily  be 
taken  to  pieces  and  put  together  again,  and  the  mercury  vessel 
can  be  easily  cleansed.  The  resistance-dial  indicates  approx- 
imately the  number  of  interrupters  per  time-unit.  An  inter- 
rupter of  another  kind,  which  gives  a  still  higher  rate  of  inter- 
ruptions, is  the  turbine-mercury  interrupter  of  the  Allge- 
meine  Elektricitats-Gesellschaft,  Berlin  (Fig.  29).  A  metal 
tube,  bent  at  right  angles,  has  one  arm  vertically  im- 
mersed in  mercury.  By  rapid  rotation  of  the  tube,  with  this 
vertical  arm  as  axis,  mercury  is  sucked  up  and  emitted  from  the 
horizontal  arm  in  the  form  of  a  jet,  owing  to  centrifugal  action. 
The  jet  strikes  a  metal  ring  perforated  at  intervals  with  aper- 
tures.     With   the  jet  striking  the  metal  ring  the  current  is 


Fig.  30. — Max  Levy's  interrupter,  Berlin. 


closed;  each  time,  however,  it  coincides  with  an  aperture  the 
current  is  opened.  Consequently  the  number  of  interruptions 
in  a  given  time  can  be  increased  by  employing  rings  with  a 


ELEMENTS  OF  ELECTRICITY 


71 


greater  number  of  apertures.  The  rate  of  interruption,  of 
course,  also  depends  upon  the  speed  of  revohition  of  the  tube 
(which  is  actuated  by  an  electro-motor  whose  speed  can  be  va- 
ried by  resistances).      The  mercury  is  covered  with  a  layer  of 

T 


Fig.  31.— Mercury-break  by  Reiniger,  Gebbcrt  and  Schall. 

alcohol.      About   150  c.cm.  mercury  and   1400  c.cm.  absolute 
alcohol  are  required  to  fill  the  interrupter. 

Max  Levy,  of  Berlin,  has  dexised  a  modification  of  the 
apparatus  (Fig.  30).  The  chief  difference  lies  in  the 
fact  that  the  mercury  jet  rotates,  and  not  the  "contact-ring." 
By  means  of  a  suitable  pump,  which  has  an  axis  in  common  with 
the  ring,  mercury  is  driven  up  the  rectangular  tube  aiul  squirted 
in  the  form  of  a  jet  against  the  contact  ring  and  its  apertures 
alternately.  The  contact-pieces  being  triangular,  w-ith  the 
apices  below,  by  adjusting  the  height  of  the  mercury  tube  it  is 
possible  to  vary  the  duration  of  the  individual  current-periods. 
The  pump  works  even  when  the  motor  is  going  very  slowly, 
so  that  this  type  of  interrupter  can  be  used  when  a  very  slow 
rate  of  interruption  is  required.  In  the  original  apparatus  a 
glass  covering  encloses  all  the  w^orking-parts;  the  condition  of 
the  mercury,  etc.,  can  thus  be  kept  under  observation  and  con- 
trol. In  Rc'mijrer,  Gebbcrt  and  Srhall's  apparatus  the  mercury 
(Fig.  31  )  is  squirted  from  a  fixetl  tube  I)  against  a  fixed  contact 
plate  C,  the  interruption  being  cftectctl  by  rotating  wing-shaped 


72  RADIO-THERAPY 

insulating  pieces  F,  which  cut  the  jet  at  intervals  and  prevent  it 
from  striking  C.  7  he  mercury  is  pumped  from  Z)  by  a  cen- 
trifugal-pump placed  in  the  case  C,  whose  axis  also  carries  the 
interrupting  wings.  The  length  of  the  mercury  jet  can  be 
varied  by  means  of  a  screw  placed  on  the  cover  of  the  appara- 
tus which  raises  or  lowers  the  contact  plate.  The  rapidity  of 
the  interruptions  depends  upon  the  rate  of  rotation  of  the  main 
axis,  the  number  of  wings  and  their  size,  and  upon  the  dis- 
tance of  the  contact  plate  from  C. 

The  turbine-mercury-jnlernipters  for  alternating  currents 
of  the  Allgemeine  Elektricitats-Gesellschaft,  Berlin,  are  con- 
structed on  the  same  principle  as  those  for  continuous  currents. 
Their  rate  of  interruption,  however,  cannot  be  changed  at  will; 
it  depends  always  upon  the  number  of  periods  of  the  alternating 
current  which  is  used,  and  this  in  most  cases  amounts  to  50 
per  second.  The  apparatus  is  constructed  exactly  on  the  same 
lines  as  the  turbine-continuous-current  interrupter.  The  motor, 
however,  is  not  fitted  at  the  side,  and  is  not  joined  to  the  turbine 
axle  by  an  endless  cord,  but  lies  over  the  interrupter  and  is  di- 
rectly coupled  with  the  axle.  The  speed  of  the  motor  exactly 
conforms  with  the  alternation-rate  of  the  current,  so  that  the 
current-closings  and  interruptions  always  occur  at  the  same 
periods  of  the  alternating  current-phase.  The  arrangement 
is  of  such  a  kind  that  the  current  is  only  closed  in  the  same  half 
of  the  current-phase,  so  that  only  current  waves  of  one  direc- 
tion enter,  their  effect  being,  therefore,  identical  with  that  of  an 
interrupted  continuous  current.  In  order  that  the  motor  may 
run  with  a  certain  velocity,  corresponding  with  the  rate  of  alter- 
nations of  curfent,  it  requires  some  regulating.  This  is  effected 
by  means  of  a  hand-wheel  which  is  pressed  against  the  axle 
of  the  interrupter  by  an  eccentric.  A  Roentgen-ray  tube  intro- 
duced within  the  secondary  circuit  of  the  coil  shows  by  its  reg- 
ular end  even  fluorescence  when  synchronism  has  been  attained 
in  the  interrupter  (Fig.  32). 

A.  Londe  and  L.  Leroy,  also  IF.  A.  Hirschmann,  con- 
structed rotary  interrupters  with  sliding  contacts  working  with- 
out mercury  jets. 

In     these     the     interruption     is     brought     about     by     a 


ELEMENTS  OE  ELECTRICrfY  73 

contact  brush  sliding  over  a  round  metal  disc  provided 
with  insulating  sectors.  1  hese  appliances  gi\-e  a  consiilerable 
rate  of  interruption  (up  to  2,000  per  minute).  Quite  recently 
an  interrupter  has  been  brought  out  which  works  on  an  entirely 
different  principle  and  is  a  simple  and  effective  apparatus.  This 
is  .:/.  Jfelinelt' s^)  electrolytic  interrupter,  in  which  all  the  parts 
are  fixed,  and  whose  effect  depends  entirely  on  electrolytic  ac- 
tion. It  can  give  an  enormous  rate  of  interruption  (from  sev- 
eral hundreds  to  2,000  per  second),  and  this  with  regularity. 


Fig.  32. — Turbine-mercury-intcrrupter   for   alternating-currents.     (Allg.    l-.lek. 
Gesellsch.,  Berlin.) 

Many  physicists  have  studied  the  peculiar  light-  and  heat-effects 
which  are  produced  by  passing  powerful  currents  from  small 
electrodes  through  a  conducting  liquid.  While  experimenting 
on  the  question  of  electrolysis  U'etineli  was  struck  by  the  hum- 
ming sound  elicited  when  the  smaller  of  the  two  electrodes 
(using  thin  platinum  wire  and  a  large  lead  plate  in  dilute  sul- 
phuric acid  solution)  was  connected  with  the  negative  pole  of 
a  powerful  battery.  Richarz  ( 1890- 189 2)  had  already  shown 
that  this  humming  sound  corresponded  with  irregularities  in  the 
current  traversing  the  Huid. 


')   Elektrotcchnisclic   Zcitsclirift.    P.erlin.    1H99.    p.    76.      Jrirdriiuinn.    An- 
Jialcn,   1899.     Rd.  LXVIII,  p    2.^.1 


74  RADIO-THER/IPY 

Wehneli  now  examined  this  inconstancy  of  the  current  more 
closely  and  found  that  it  consisted  of  a  series  of  total  interrup- 
tions. It  is  calculated  from  the  position  of  the  humming  sound 
in  the  scale  that  there  are  some  1,700  interruptions  per  second. 


Fig.  :^2. — spark     et'ftcts     with     an     instrument     (electrolytic-interrupter)     by 
Max  Levy,  Berlin. 

Acting  on  these  observations,  the  idea  occurred  to  U^ehnelt 
of  placing  an  electrolytic  apparatus  in  the  primary  circuit  of  a 
coil;  he  thus  obtained  a  most  effective  interrupter.  With  higher 
tensions  (i  10  volts)  the  smaller  (negative)  electrode  soon  be- 
came red-hot  and  melted  away,  the  spark-stream  of  the  sec- 
ondary circuit  becoming  feeble  and  irregular.  Much  better 
results  were  obtained  when  the  smaller  (the  "active")  electrode 
was  made  positive  (anodal)  and  the  larger  one  negative  (cath- 
odal). "The  result  was  surprising.  On  passing  the  currents 
(about  100  volts)  a  powerful  arc-light  was  produced  between 
point  and  plate  of  the  secondary  coil  terminals.  When  point 
and  plate  were  separated  for  about  25  cm.  this  arc-light  was 
broken  up  into  a  sheaf  about  the  thickness  of  a  lead  pencil, 
composed  of  innumerable  sparks  interwoven  one  with  another.'* 
Fig.  33  gives  an  illustration  of  this  phenomenon. 


ELEMENTS  OE  ELECTRICnY 


75 


If  the  Ruhmkorfs  coil  be  excluded  from  the  current-circuit 
no  interruption  occurs,  but  the  acti\e  electrode  immediately  be- 
gins to  glow ;  on  introducing  the  coil  this  glowing  ceases  and  a 
distinct  sound  is  heard,  the  note  of  which  corresponds  with  the 
interruption-rate.  A  reddish-yellow  veil  of  light  now  sur- 
rounds the  acti\e  electrode,  but  when  the  latter  is  also  negative 
this  light  becomes  of  a  bluish-white  tint.  Spectrum  analysis 
shows  in  the  former  instance  the  spectrum  of  hvdrogen,  in  the 
latter  that  of  platinum. 

The  foregoing  observations  show  that  the  active  electrode 
must  be  connected  with  the  positi\e  and  the  other  electrode 
with  the  negative  pole  of  the  main  current  in  order  to  obtain 
good  and  constant  action  of  the  electrolytic  interrupter.  The 
most  common  form  of  this  interrupter  consists  of  a  large  square 
glass  vessel  covered  by  a  perforated  Nulcanlte  lid.      On  the  lat- 


FiG.  34. — Max  Kohl's  cIcclrulNtic  inttTniptcr.   Clieniiiitz. 

ter  lies  a  terminal  in  connection  witii  the  negatixe  lead  plate. 
A  metal  roil  j)ierccs  the  liil,  bearing  at  its  lower  end  a  platinum 
pin,  while  a  porcelain  tube  encloses  the  rod  itself.  Some  acid 
always  rises  between  the  anode-pin  and  the  porcelain  tube;  this, 


76  RADIO-TtlERAPY 

if  allowed  to  rise  as  far  as  the  vessel  lid,  would  penetrate  the 
fittings  of  the  tube  and  rod,  and  so  reach  the  surface,  thereby 
causing  a  side-circuit.  It  is,  therefore,  necessary  to  allow  a 
vent  for  this  unavoidable  rising  of  the  acid  (which  is  partly  an 
effect  of  the  explosion),  and  this  is  done  by  fixing  a  small  glass 
tube  on  one  side  of  the  upper  part  of  the  porcelain  tube.  The 
upper  end  of  the  metal  rod  (anode)  is  connected  with  the 
positive  pole  of  the  main  supply  by  means  of  a  terminal  screw. 
Here,  also,  is  a  regulating  screw  by  which  the  platinum  pin 
may  be  made  to  emerge  more  and  more  from  the  porcelain 
tube;  thus  the  active  surface  of  the  anode  (i.  e.,  that  part  of  it 
through  which  the  current  enters  the  fiuid)  may  be  increased 
or  diminished  at  will. 

Other  things  being  equal,  the  rate  of  interruptions  depends 
upon  the  area  of  this  active  surface;  the  greater  the  surface,  the 
lower  the  interruption-rate.  Thus  by  increasing  the  active  sur- 
face of  the  platinum  pin,  by  pushing  it  further  out  of  its  insu- 
lating cover,  the  rate  of  interruptions  is  lowered;  on  the  other 
hand,  the  current-strength  is  increased.  If  one  increases  ten- 
sion by  switching  off  resistances  at  the  current-regulator,  with- 
out at  the  same  time  increasing  the  platinum  anode-surface,  the 
rate  of  interruption  and  the  current-strength  are  both  aug- 
mented. This  is  at  once  made  evident  by  the  louder  humming 
sound,  the  pitch  of  which  is  raised. 

Other  factors  on  which  the  interruption-rate  depends  are 
the  resistance  and  the  self-induction  of  the  circuit  made  and 
broken  by  the  interrupter.  Now  the  part  both  these  factors 
play  bears  relation  to  the  fact  that  the  interruption  takes  place 
at  a  certain  current-strength,  penetrating  through  the  surface- 
unit  of  the  active  surface.  This  current-strength  must  be  at- 
tained before  an  interruption  can  possibly  occur.  The  time 
required  for  this  purpose  depends  to  a  great  extent  upon  the 
resistance  and  the  self-induction  of  the  current-circuit,  as  we 
ha\'e  learned  from  the  theories  relating  to  current-closing.  The 
smaller  the  self-induction,  the  greater  the  number  of  interrup- 
tions per  second.  In  the  case  of  a  circuit  without  self-in- 
duction the  apparatus  does  not  work,  but  gives  one  interruption 
only.      Without  self-induction  in  the  closing-circuit  the  tension 


ELEMENTS  OF  ELECTRICITY  77 

required  for  the  production  of  the  above  phenomena  is  gen- 
erally a  higher  one.  The  current-interruptions  of  an  electro- 
lytic interrupter  are  of  such  a  kind  that  no  condenser  is  required 
for  the  coil.  Self-induction,  which  in  other  cases  is  most  care- 
fully a\oided,  or  at  least  minimised  as  far  as  possible,  is  not 
only  absolutely  harmless  when  using  interrupters  of  the 
irehnelt  type,  but  actually  favours  the  production  of  the  Roent- 
gen-tube phenomena  and  exact  interruptions. 

folic?-  and  JJ\iltc'r  explain  this  peculiarity  by  the  fact  that 
the  primary  opening  tension  (which  with  other  interrupters 
produces  disturbing  secondary  effects  with  the  opening-spark- 
ing, having,  therefore,  to  be  diverted  into  the  condenser)  is 
actually  a  favourable  factor  with  electrolytic  interrupters  by 
reason  of  its  decomposition-effect  on  the  water-gases,  whereby 
the  continuity  of  the  current  can  be  restored. 

In  some  recent  Roentgen-ray  apparatus  the  electrolytic  in- 
terrupter is  so  arranged  that  in  order  to  work  tubes  of  varying 
degrees  of  hardness  several  (3  to  6)  different  sizes  of  active 
electrodes  are  employed.  7'hese  may  be  switched  on  at  the 
connecting-board  without  having  the  troublesome  arrangement 
of  the  platinum-pin  to  go  through.  {JT alter  and  Albcrs- 
Schonberg' s  compound  Wehnelt.) 

//'.  A.  HirschmcDin's  electric  interrupter  with  surface  con- 
tacts (Figs.  35  and  36)   consists  of  a  platinum  plate  lying  be- 


^mmm,^^ 


D.  R.  P.    angem. 
Fig.  35. 

tween  two  porcelain  surfaces,  and  in  connection  with  the  posi- 
tive wire,  and  also  a  rod-shaped  leaden  electroilc,  the  si/e  of 
which  is  varied  according  to  the  current-strength.  The  plat- 
inum electrode  may  be  converted  at  any  time  into  another  of 
different  thickness.  By  this  arrangement  not  only  is  a  smaller 
current  consumption  secured,  but  another  practical  aihantage 
is  gained.      For  any  defect  in  the  porcelain  tube  arising  Irom 


78 


RADIO-THERAPY 


wear  and  tear  can  be  repaired  by  simply  grinding  off  the  end 
of  the  tube.  With  other  electrolytic  interrupters  the  porce- 
lain tube  after  a  time  becomes  hollowed  out  by  the  flame  pro- 
ceeding from  the  platinum  pin,  whereby  it  is  rendered  useless 


Fig.  36. 


and  must  be  replaced.  Interrupters  of  this  type  are  also  con- 
structed with  several  pairs  of  electrodes. 

In  order  to  gain  a  proper  conception  of  the  events  taking 
place  in  an  electrolytic  interrupter,  it  is  necessary,  as  roller  and 
fr (liter  have  shown,  to  examine  the  gases  appearing  at  the 
electrodes,  both  in  regard  to  quantity  and  kind.  We  find  the 
gas  evolved  at  the  active  electrode  consists  of  not  only  oxygen, 
which  must  appear  at  the  anode,  but  also  of  hydrogen,  which 
with  normal  electrolysis  appears  at  the  cathode. 

This  apparent  abnormality  might  be  explained  by  assuming 
that  the  great  heat  attained  in  the  locality  of  the  active  elec- 
trode (resulting  from  the  narrow  sectional  area  of  the  conductor 
here)  causes  an  evaporation  and  decomposition  of  the  water, 
so  that  in  addition  to  the  oxygen  which  is  electrolytically  sep- 
arated, both  hydrogen  and  oxygen  appear  from  the  steam.  The 
cause  of  the  interruption  may,  therefore,  be  found  in  the  gas- 
eous envelopment  of  the  active  electrode.  As  soon,  however, 
as  the  current  (and  with  it  the  heat-supply)  is  cut  off,  condensa- 
tion of  the  steam  occurs  by  the  surrounding  cold  liquid,  where- 


ELEMENTS  OF  ELECTRICITY 


79 


bv  the  current  circuit  is  restored.  It  may  be  mentioned  in  proof 
of  this  theory  that  as  soon  as  the  water  has  reached  a  tempera- 
ture of  90'  C,  whereby  condensation  can  no  longer  take  phice, 
the  apparatus  ceases  to  work.  The  action  of  the  apparatus  is 
helped  by  the  opening-spark,  which  flies  through  the  zone  of 
steam  and  gas  round  the  anode  (hence  the  luminosity  in  this 
region),  thereby  favouring  the  union  of  hydrogen  and  oxygen 
in  case  these  have  not  ah-eady  escaped. 

The  foregoing  gives  an  outline  of  the  theories  which 
irehnelt  formed  on  the  mode  of  action  of  his  interrupter. 
Moreover  Simon  ^)  considers  that  the  heat  developed  so  ener- 
getically in  certain  parts  of  the  current-circuit,  as  described 
abo\-e,  may  be  regarded  as  the  essential  cause  of  the  interrup- 
tion. On  this  hypothesis  he  has  formulated 
a  theory  of  irclinclt's  interrupter  which  is 
certainly  in  harmony  with  experiment,  so 
far  as  the  interruption-rate  is  concerned. 
A  double  cell  (fig.  37,  A  A)  with  two 
large  lead  plates  F  F  as  electrodes,  divided 
by  a  porcelain  partition  D,  which  is  fur- 
nished with  one  or  more  small  apertures, 
should  act  as  an  interrupter  {CaldzvcU-  Fig.  37.  —  Platinum- 
Simon  interrupter).     This  is  found  to  be         mten-uptcr.    (After 

,  ^,,       .  -11  Ruliiiicr,     l)v     Max 

the  case.      1  he  mterruption  takes  place  at         ^^,^,^,  Berlin) 

the  small  aperture  through  which  the  cur- 
rent is  made  to  pass.  Here  watery  vapour  is  periodically 
evolved,  followed  each  time  by  condensation,  and  thus  the 
current  is  alternately  broken  and  made.  According  to 
Simon,  this  interrupter  diHers  from  frdinell's  m  being  inde- 
pendent of  the  current  direction,  working  equally  well  with 
continuous  or  alternating  currents.  The  apparatus,  more- 
over, docs  not  stop  working  when  the  acid  has  become  heated 
after  long  working.  irclinclt's  apparatus,  as  has  been  men- 
tioned, is  useless  when  once  a  temperature  of  90"^  C.  has 
been  attained.  lyArsonzul  found  that  If  clinch's  interrupter 
works  well  with  an  alternating  current  of  110  volts,  and  is  as 


')    Elcktrotcchn.  Zcitschr.,   1H99,  p.  440. 


8o 


RADIO-THERAPY 


good  for  Roentgen  work  under  these  conditions  as  a  continuous 
current.  This  proves  that  the  current  interruption  only  takes 
place  during  one  phase.  The  effect  on  the  interrupter  during 
that  phase  when  the  active  electrode  is  negative  is  quite  insig- 
nificant, and  may  be  disregarded.      When  using  an  alternating 


Fig.  38. — Max   Levy's   platinum-Interrupter,    Berlin. 


current  the  wear  and  tear  of  the  platinum  pin  is  considerable; 
it  requires,  therefore,  to  be  made  of  corresponding  strength 
and  size. 

Simon's  interrupter  acts,  however,  with  each  phase  of  an 
alternating  current,  being  independent  of  the  current-direction, 
and  is  consequently  not  suitable  for  X-ray  work  in  its  original 
form.       By  utilising  a   property  of  aluminium   discovered  by 


ELEMENTS  OF  ELECTRICITY  8i 

Poll(ik^)  and  Graetz-),  however,  this  interrupter  may  be  so 
modified  that  by  its  use  an  alternating  current  may  be  made 
continuous.  These  observers  found  that  by  employing  this 
metal  as  anode  a  great  resistance  is  offered  to  the  current's 
passage  in  certain  electrolytic  liquids  (especially  potash  and 
soda),  and  that  if  the  tension  does  not  exceed  a  certain  limit  the 
current-flow  is  completely  barred.  If,  then,  one  of  the  lead 
electrodes  F  (Fig.  37)  be  replaced  by  an  aluminium  plate,  the 
current  only  flows  through  to  the  primary  coil  when  the  alumin- 
ium is  acting  as  cathode. 

The  plate-internipter  is  a  modification  of  Simon's  appara- 
tus. In  order  to  alter  the  size  of  the  plate-apertures,  and 
thereby  the  rate  of  interruption,  the  apparatus  is  provided  with 
porcelain  plates  D  having  holes  of  different  sizes.  The  plates 
are  interchangeable.  Over-heating  from  high  current-strengths 
or  prolonged  use  is  pre\'ented  by  means  of  a  system 
of  cold-water  circulation  through  a  porcelain  tube  E  attached 
to  the  lid  of  the  apparatus: 

The  use  of  electro-magnetic  induction  apparatus  in  radio- 
therapy will  be  discussed  in  later  chapters. 


0   Elektrotechn.  Zeitschr.,   1897,  p.  359. 

")    Sitzungsber.  d.  k.  bayr.   Akad.  d.  Wissensch.   i  Mai,   1897. 


II. 

TREATMENT    WITH    HIGH-FREQUENCY 
CURRENTS. 


TREATMENT  WITH   HIGH-FREQUENCY 
CURRENTS.^ 

§  21.  High-Frequency  Currents. 

In  the  year  1 88  i  Morton-)  described  a  method  of  using  elec- 
tricity for  the  local  treatment  of  muscle  and  nerve  disorders. 
He  brought  the  terminals  of  the  discharger  of  an  electrical 
machine  so  near  together  that  sparks  passed  between  them. 
He  then  put  his  patient  in  the  circuit  connecting  the  tin-foils  of 
the  condensers.  Alorton  was  the  first  to  produce  by  means 
of  this  arrangement  and  to  therapeutically  apply  high-fre- 
quency currents,  for  he  had  used  the  oscillating  character  of  the 
condenser-discharge  to  Increase  the  frequency  of  an  alternating 
current.  The  condensers  were  charged  in  this  case  through  an 
induction  apparatus.  Morton's  high-tension  oscillating  cur- 
rents have  been  used  by  Lediic'-^)  and  F.  Jt^inkler*)  in  similar 
affections,  and,  of  course,  with  results  similar  to  those  produced 
by  other  forms  of  high-frequency  apparatus. 

In  the  year  1893  Tesla  described  an  arrangement  by  which 
he  produced  currents  of  rapid  alternations  and  high-tension. 
He  passed  them  through  glass  tubes  containing  a  partial 
vacuum,  thereby  obtaining  brilliant  effects  of  Illumination. 
These  currents  of  Tesla  are  of  great  medical  interest,  since  they 
produce   powerful   physiological   effects,    and   may  be   applied 


')  Literature  referred  to:  Doumcr,  Annales  d'electrobiologie,  electrodi- 
agnostique  et  elcctrotherapie.  Vol.  I-IV.  —  Dr.  H.  Kurclla,  Zcitschrift  fur 
Elcktrotherapie  und  arztl.  Elektrotechnik.  Vol.  I-IV. — Fotivcan  dc  Cour- 
melles,  L'annee  electrique.  1900,  1901.  —  F.  Winkler,  Festschrift  fiir  Hofrath 
Prof.  Neumann,  1900.  —  L.  Bouchacourt  and  A.  Remond,  Annales  d'electro- 
biologie, 1900.  Vol.  Ill,  p.  334. — Reiniger  (Gebbert  &  Schall's  Catalogue, 
1902). 

*)    Quoted  by  Doumcr  &  Ondin.  Ann.  d'c'lcctroljiologic,   IQOO,  p.  507. 

')   Compt.   rend,  du  XII  Cong.  int.  de  Medicines.    Vol.  II,  Sec.  IVa,  p.  70. 

*)  Wiener  med.  Presse,  1900,  No.  41. 


86  RADIO-rHERAPY 

successfully  In  the  treatment  of  various  diseases.  In  order  to 
understand  Tesla's  discovery,  one  must  have  some  knowledge 
both  of  the  laws  of  electrical  induction  and  of  the  phenomena 
accompanying  the  discharge  of  a  Ley  den  jar.  We  know  that 
electricity  at  the  moment  of  its  appearance  and  disappearance 
induces  electricity  in  a  neighbouring  conductor,  and  we  know 
that  one  can  produce  alternating  currents  of  high  tension  by 
means  of  induction  apparatus.  We  have  already  learned 
(p.  i8)  that  when  a  Leyden  jar  is  discharged  the  whole  posi- 
tive and  negative  quantities  of  electricity  are  not  dissipated,  but 
that  many  discharges  of  gradually  decreasing  intensity  occur 
at  very  short  intervals  afterwards. 

These  facts  have  been  known  for  many  years.  They  were 
first  theoretically  deduced  by  Kirchhoff  and  Thomson,  who  ap- 
plied to  electricity  the  laws  already  known  dealing  with  the 
motion  of  liquids.  Under  like  conditions  the  behaviour  of 
electricity  may  be  compared  with  that  of  water  which  Is  accu- 
mulated in  two  vessels  in  communication  with  each  other  at 
the  bottom  by  means  of  a  wide  pipe.  If  the  water  level  be  low- 
ered in  one  vessel  so  that  it  rises  In  the  other,  on  leaving  the 
liquid  to  itself  repeated  alterations  In  the  level  will  occur  where- 
by the  water  repeatedly  flows  to  and  fro  within  the  pipe;  the 
two  columns  of  water  will  oscillate  until  equilibrium  is  finally 
established.  Now  the  same  thing  occurs  when  the  positively 
and  negatively  charged  tin-foils  of  a  Leyden  jar  are  brought 
into  contact.  The  electricities  counterbalance  themselves  In 
the  same  way  as  do  the  differences  of  water  level  In  the  commu- 
nicating vessels.  The  process  of  discharging  Is  not  completed 
In  one  transition  of  electricity  from  the  Inner  to  the  outer  tin- 
foil, but  a  repeated  passage  of  electricity  to  and  fro  occurs. 

It  would  seem  as  though  electricity  possessed  inertia,  though 
this  is  not  the  case.  Self-induction  takes  the  place  of  "vis  In- 
ertlae."  When  the  excess  of  electricity  begins  to  flow  from  the 
Interior  of  the  Leyden  jar  (M^hlch  we  will  suppose  to  be  charged 
at  the  beginning  with  positive  electricity)  an  excessive  amount 
goes  to  the  outer  tin-foil,  leaving  the  Interior  of  the  jar  lacking 
In  positive  electricity;  the  inner  foil  is  thereby  negatively 
charged.      The  superfluous  positive  electricity  collected  on  the 


HIGH-FREQUENCY   CURRENTS  87 

outside  flows  back  again  to  the  inside,  but  again  in  excess,  so 
that  a  new  current  of  electricity  is  produced  in  the  opposite 
direction. 

When  the  conducting  wires  of  the  two  tin-foils  are  brought 
near  together  a  spark  results.  The  electricities  in  this  spark 
are  in  reality  flashing  to  and  fro  until  equilibrium  becomes 
established.  This  phenomenon  is  called  electrical  oscillation. 
Clark  Maxwell  showed  that  a  kind  of  magnetic  transverse 
undulation  occurs  in  the  space  surrounding  a  conductor  where 
this  electrical  oscillation  is  going  on.  This  undulation  he  be- 
lieved to  possess  all  the  qualities  of  waves  of  light,  and  that 
while  it  may  be  transmitted  with  any  wave  length  it  must 
always  hav^e  the  velocity  of  light,  /.  e.,  300,000  km.  per  second 
{the  electro-magnetic  theory  of  light). 

Hertz  proved  experimentally  that  an  electro-magnetic  dis- 
turbance is  as  an  eftect  of  induction  transmitted  with  the  veloc- 
ity of  light  through  space,  and  that  these  electric  waves  possess 
the  same  qualities  as  light.  It  is  indisputable  that  electro-mag- 
netic induction,  electric  and  magnetic  manifestations  are  trans- 
mitted through  the  air  not  instantaneously,  but  with  the  ve- 
locity of  light.  An  electrical  wave  of  this  kind  would, 
therefore,  be  identical  with  a  light  wave.  As  far  as  we  know, 
the  source  of  electrical  oscillation  is  to  be  found  in  the  discharg- 
ing of  larger  or  smaller  quantities  of  electricity. 

Kirchhofj  has  proved  that  electrical  discharges  are  trans- 
mitted not  only  in  the  air  but  also  along  wires  with  the  velocity 
of  light.  Lecher  showed  that  the  transverse  ether  waves  are 
transmitted  between  parallel  wires  in  a  direction  parallel  to  the 
latter,  whereas  the  direction  of  the  waves  of  the  main  current, 
of  the  electrical  force,  is  perpendicular  to  the  surface  of  the 
wire. 

Hertz  proved  that  from  such  electric  vibration  ether 
waves  proceed  which  are  transmitted  through  space  and 
non-conducting  bodies  (dielectrics)  with  a  velocity  which 
in  the  air  is  almost  equal  to  that  of  light.  These  waves 
of  electric  power  are  subject  to  the  same  lawsof  reflection, 
refraction  and  polarisation  as  ordinary  light.  Hertz 
reflected  the  waves  from  a  perpendicular  screen  of  metal ; 


88  RADIO-THERAPY 

"fixed  waves"  were  formed  by  interference  between  di- 
rect and  reflected  waves,  between  the  primary  conductor 
and  the  screen.      In  other  words,  at  certain  points  there 
was  no  ether  vibration.      Hertz's  electric  waves  pene- 
trate insulating  bodies,  such  as  glass,  paraflin,  sulphur, 
wood,  but  never  metals. 
The  current  flowing  through  the  wires  in  this  experiment 
is  repeatedly  changing  its  direction ;  it  is  an  alternating  current. 
The  current-reversals  produced  by  discharging  Leyden  jars  are 
extraordinarily    rapid    {alternating    high-frequency    currents); 
it  has  been  proved  that  they  may  take  place  100,000  times,  even 
1,000,000  times  per  second.      (Alternating  currents  as  supplied 
for  ordinary  purposes  do  not  usually  change  their  direction 
more  than   So  times  per  second.)       This  alternating  current 
soon  loses  intensity.      But  when  an  immediate  re-charging  of 
the  Leyden  jar  is  provided  for  by  suitable  apparatus  a  perma- 
nent alternating  current  can  be  supplied. 

Tesla  produced  a  series  of  remarkable  phenomena  by  means 
of  the  electric  oscillations  caused  by  the  discharging  of  Leyden 
jars.  When  the  current  of  an  ordinary  alternating-current  ma- 
chine is  conveyed  through  the  inner  winding  of  an  induction 
coil  the  latter  shows  very  powerful  induction  effects;  the  alter- 
nating-currents produced  by  the  secondary  coil  are  strong 
enough  to  light  an  incandescent  lamp  placed  in  their  circuit. 
The  inducing  power  becomes  greater  when  the  rate  of  alterna- 
tion is  increased. 

Tesla  alternatively  charged  and  discharged  Leyden  jars  by 
means  of  alternating-currents,  by  rapidly  succeeding  currents 
from  a  Ruhmkorff' s  coil,  thereby  intensifying  the  frequency  of 
the  currents.  He  converted  these  comparatively  strong  high- 
frequency  currents  into  currents  of  extraordinarily  high  tension 
by  conveying  them  through  a  primary  coil  of  slight  resistance 
(and  self-potential)  ;  over  this  primary  coil  he  placed  a  sec- 
ondary one,  formed  by  numerous  windings  of  thin  wire.  He 
thus  obtained  induction-currents  of  remarkably  high-tension  and 
high-frequency.  Primary  and  secondary  colls  together  are  called 
Tesla's  transformers. 

In  Fig.  39  we  have  a  sketch  of  Tesla's  apparatus.      The 


HIGH-FREOVEXCY   CURRENTS 


89 


inner  tin-foils  of  the  Leyden  jars  C^  and  Co  are  positively  and 
negatively  charged  from  the  secondary  terminals  of  the 
Ruhmkorff's  coil  A.  The  outer  tin-foils  are  in  connection 
through  the  primary  winding  P  P  of  Tesla's  transformer  and 
through  the  spark-gap  B.  Alternating-currents  are  produced 
in  the  primary  coil  of  the  transformer;  they  are  synchronous 
with  the  oscillations  of  the  discharge  in  the  spark-gap.  These 
high-frequency  alternating  currents  induce  alternating  currents 
in  the  secondary  coil  5  S;  these  currents  combine  high-fre- 
quency with  high-tension.      On  account  of  the  enormous  ten- 


FiG.  39. 

sion  obtaining  in  the  windings  of  the  secondary  coil  of  the 
transformer,  the  latter  requires  to  be  immersed  in  oil,  which 
forms  the  only  satisfactory  insulating  medium ;  otherwise 
sparks  would  inevitably  pass  between  the  separate  windings  of 
the  wire  and  soon  destroy  the  apparatus. 

These  high-frequency  currents  ( Tesla's  currents)  possess 
some  extraordinary  physical  properties.  They  do  not  require 
a  closed  conductor  for  their  transmission;  they  are  transmitted 
as  electric  waves  through  the  air.  They  ilkiminatc  Geisslcrs 
tubes  even  from  a  considerable  distance.       J'hcy  also  possess  a 


90  RADIO-THERAPY 

quality  which  is  of  a  special  meciical  interest:  they  are  devoid 
of  danger  despite  their  enormous  tension.  When  we  consider 
that  ordinary  alternating  currents  of  about  2,000  volts'  tension 
are  very  dangerous  to  life,  it  is  an  extraordinary  fact  that  these 
alternating  currents,  though  possessing  a  tension  of  a  hundred 
times  greater,  are  absolutely  harmless.  An  electrode  of  a 
Tesla  transformer  may  be  touched  with  a  metallic  rod  held  in 
the  hand,  without  danger.  An  incandescent  lamp,  the  poles  of 
which  are  held  by  the  experimenter  and  an  assistant,  will  be  illu- 
minated the  moment  the  current  of  sparks  passes  into  the  metal- 
lic rod.  The  experimenter's  body  forms  part  of  the  conductor 
for  the  current  which  is  illuminating  the  lamp;  the  current  must, 
therefore,  be  of  considerable  intensity;  nevertheless  it  does  no 
harm  and  causes  no  disagreeable  sensation. 

This  fact  was  known  to  the  French  physiologist  A.  d'Arson- 
val,  even  before  Tesla.  D' Arsonval  proved  that  a  solenoid 
traversed  by  high-tension-currents  induces  powerful  currents  in 
an  organism  which  it  encloses.  A  man's  body  placed  within  a 
large  solenoid  forms  an  electric  conductor  in  which  currents 
are  induced  of  the  same  high-frequency  as  those  in  the  solenoid. 
When  the  man  within  the  solenoid  forms  a  circle  with  his  arms 
which  is  closed  by  a  small  incandescent  lamp,  the  latter  becomes 
lighted  by  the  induced  currents  circulating  through  his  arms. 
According  to  d! Arsonval,  this  experiment  is  more  successful  if 
the  subject  of  the  experiment  first  moistens  his  hands  with  a  sat- 
urated solution  of  sal  ammoniac.  By  so  doing  the  resistance 
between  the  two  hands  is  lessened  by  about  600  ohms.  The  ex- 
periment can  also  be  performed  with  other  animals,  e.  g.,  eels. 
Although  this  procedure  acts  very  vigorously  on  the  organism, 
no  sensation  is  produced.  D' Arsonval  published  the  results  of 
his  experiments  in  1891,^)  but  he  employed  a  rather  different 
apparatus  to  that  of  Trshi. 

There  are  two  FrajikVui  plates  (condensers)  C  (Fig.  40)  ; 
the  tin-foils  of  one  side  of  these  plates  are  in  circuit  with  the 
poles  of  the  secondary  coil  of  the  induction  apparatus  A  and 
spark-gap  B.    The  tin-foils  of  the  other  sides  are  connected  by 


')    Societe  de  Biologic,  Feb.  24  and  April  24.  1891. 


HIGH-FREQUENCY   CURRENTS  91 

a  thick  copper  wire  /J,  which  forms  a  little  solenoid  having  from 
15  to  20  windings.  Besides  this  smaller  solenoid  a  larger  one 
E  can  be  placed  in  the  circuit  of  the  discharge-current  at  H ; 
the  patient  is  placed  within 
the  larger  solenoid.  Syn- 
chronously with  every  dis- 
charge through  the  spark- 
gap  a  corresponding  dis- 
charge takes  place  on  the 
tin-foils  of  the  condensers  in 
connection  with  the  sole- 
noid. These  discharges  pass 
through  the  solenoid,  where 
in  consequence  high  -  fre- 
quency currents  arise  which 
are  synchronous  with  the 
oscillations  of  the  discharge- 
spark  at  the  condenser,  and 
possess  about  the  same  high- 
tension  as  currents  from  an 
electro  -  static  machine 
(about  20,000  volts). 
D' Arsonval  originally  ar- 
ranged the  experiment  so 
that  the  terminals  of  a 
"shunt"  were  in  connection 
with    two    windings   of   the 

solenoid  D.     This  formed  a  conductor  of  weak  resistance  and 
helped  in  the  production  of  self  induction^ 

The  effect  of  the  high-frequency  currents  in  the  shunt  was 
more  intense  when  its  points  of  contact  were  far  apart.  The 
maximum  effect  was  gained  when  the  contact  was  connected  with 
the  first  and  last  winding. 

The  high-frequency  currents  passing  through  the  solenoids 
create  an  electric  field  in  their  vicinity.  "I  his  can  be  demon- 
strated by  the  fact  that  an  incandescent  lamp  placed  in  a  metallic 


Fig.  40., 


')   A  movable  core  of  soft  iron  witliiii  the  solenoid  also  helps  in  this  way. 


92  RADIO-THERAPY 

circle  which  is  suspended  within  the  solenoid  E  without  contact 
with  the  same  is  illuminated  as  soon  as  the  solenoid  is  traversed 
by  the  high-frequency  currents.  If  the  bulb  of  a  thermometer 
be  wound  round  with  several  turns  of  thick  copper  wire,  through 
which  high-frequency  currents  are  passing,  the  mercury  in  the 
bulb  becomes  heated  and  may  even  be  brought  to  boiling  point. 
The  electric  field  existing  in  the  vicinity  of  high-frequency  cur- 
rents has  a  marked  effect  in  the  cure  of  several  diseases.  D'Ar- 
sonval  utilised  this  physiological  effect  on  the  human  body  by 
exposing  the  whole  body  of  the  patient  to  the  influence  of  the 
electric  field  ("general  treatment") . 

Faraday,  Maxwell  and  Hertz  found  that  conductors  had 
the  effect  of  localising  the  electric  oscillations  on  their  surface, 
so  preventing  them  from  becoming  diffused;  acting  on  this  idea 
Oud'in  arranged  an  apparatus  by  means  of  which  high-frequency 
currents  could  be  localised  and  made  to  act  on  circumscribed 
parts  of  the  body.  He  constructed  an  apparatus  like  a  tuning 
fork,  having  a  certain  rate  of  vibrations;  through  this  the  high- 
frequency  currents  w^ere  passed,  while  a  second  tuning  fork  was 
brought  near  the  first  (both  forks  being  In  tune  with  each 
other).  When  the  first  fork  vibrated  the  second  also  vibrated 
in  sympathy  with  it,  producing  the  same  note.  Hertz  proved 
by  means  of  this  instrument,  which  he  called  a  resonator,  that 
within  the  compass  of  the  waves  of  a  primary  electric  conductor 
vibrations  are  induced  in  another  (secondary)  conductor;  these 
are  strongest  near  the  elevations  of  the  waves  and  weakest  near 
the  nodal  points.  The  intensity  of  electrical  resonance  depends 
upon  the  shape  and  size  of  the  secondary  conductor.  Hertz 
found  that  a  resonator  of  a  definite  capacity  is  necessary  for  a 
given  primary  apparatus  in  order  to  obtain  the  best  effect.  The 
resonator  must  be  tuned  to  the  primary  conductor. 

Oudin  proved  that  the  electrical  vibration  In  the  resonator 
depends  directly  upon  the  capacity  and  self-induction  of  the  cir- 
cuit formed  by  the  resonator. 

The  vibrations  which  occur  in  a  d'Arsonval's  solenoid  may 
be  used  as  "primary"  oscillations;  differences  of  electrostatic 
tension  will  arise  in  every  conducting  body  of  a  certain  capacity 
placed  near  the  solenoid,  and  these  differences  will  produce  cur- 


HIGH-FREQUENCY   CURRENTS  93 

'"^ 
rents  in  the  body  itself.  When  the  conductor  is  formed  of  sev- 
eral windings  of  copper  wire,  currents  will  be  formed  by  self-in- 
duction in  the  separate  windings  strong  enough  to  enable  sparks 
to  be  drawn  from  the  end  of  the  conductor;  here,  too,  the  maxi- 
mum of  efficiency  will  be  obtained  with  bodies  of  a  definite 
electric  capacity.  This  capacity  must  be  variable  according  to 
the  construction  of  the  high-frequency  apparatus  which  is  being 
used.  Metallic  bodies  placed  in  the  neighbourhood  of  the  sole- 
noid emit  a  very  long  spark  or  none  at  all,  according  as  the  rate 
of  vibration  produced  in  them  is  Increased  or  decreased ;  in 
other  words,  the  capacity  of  the  body  has  to  be  tuned  to  that  of 
the  solenoid.  These  differences  become  still  more  marked  when 
the  body  is  connected  to  the  solenoid  through  a  metal  wire;  but 
they  are  only  then  shown  when  the  body  possesses  a  certain 
self-induction.  Thus  such  effective  vibrations  can  be  produced 
in  proportion  to  the  self-induction  and  capacity  of  the  body  as 
to  give  very  long  sparks.  If  one  of  these  factors,  either  the 
self-induction  or  capacity,  be  altered,  the  oscillations  rapidly 
diminish,  and  may  even  disappear  entirely  when  only  a  slight 
difference  obtains  between  the  two  factors. 

Oiidin's  resonator  considerably  increases  the  tension  of  the 
high-frequency  current;  it  is  easily  adjustable,  so  that  it 
can  be  adapted  to  all  phases  of  d' Arsonval' s  apparatus,  i.  e.,  it 
can  be  tuned  to  another  electrical  pitch.  In  effect  the  resonator 
consists  simply  of  a  solenoid  of  copper  wire  having  a  low  re- 
sistance, which  is  wound  round  an  insulating  cylinder.  When 
one  end  of  d'Arsonval's  solenoid  D  is  connected  by  wire  with 
a  certain  point  of  this  resonator  a  powerful  and  continuous 
aigrette  of  sparks  becomes  visible  at  the  end  of  the  resonator. 
In  this  attached  resonator  the  electrical  oscillation  takes  place 
synchronously  with  that  in  the  connecting  wire  (solenoid). 

By  a  suitable  arrangement  an  aigrette  of  sparks  9  to  10  cm. 
in  length  may  be  emitted  from  the  resonator,  while  that  from  the 
primary  solenoid  is  only  15  to  20  mm.  in  length.  When  the 
point  of  contact  of  the  wire  is  moved  some  centimetres  in  one 
direction  or  the  other,  the  length  of  the  sparks  becomes  rajildly 
diminished.  The  secondary  solenoid  must,  therefore,  be  tuned 
to  the  primary  in  order  that  Its  vibrations  may  be  synchronous. 


94  RADIO-THERAPY 

When  the  capacity  of  this  resonator  is  increased  by  connect- 
ing its  free  end  with  a  wire  terminating  in  an  electrode,  the  rate 
of  oscillation  is  modified;  in  this  case  the  point  where  the  current 
enters  the  resonator  must  be  altered  in  order  to  obtain  at  the 
electrode  the  same  aigrette  and  the  same  spark  as  were  emitted 
by  the  resonator  without  the  electrode.  It  is  only  the  last  spiral 
of  the  resonator  or  a  conductor  joined  to  it  which  emits  sparks. 
The  effect  of  the  remaining  windings  upon  each  other  prevents 
them  from  giving  discharges  into  the  air.  When  a  larger  ca- 
pacity is  added  to  the  resonator,  e.  g.,  larger  Leyden  jars,  the 
sparks  grow  more  vigorous  and  may  cause  a  painful  sensation. 
{Oudin  consequently  only  used  small  condensers.)  A  res- 
onator which  is  made  of  thin  wire  emits  a  thin,  long,  sinuous  and 
comparatively  painless  spark,  and  the  aigrettes  (or  quiet  dis- 
charges) are  less  vigorous.  By  using  the  thicker  wire  both 
discharge  and  spark  grow  more  powerful. 

§  22.  Apparatus. 

Direct  currents  from  the  main,  accumulators,  or  bi-chromate 
batteries  of  about  6  ampere  intensity  are  usually  employed  as 
generators  of  high-frequency  currents  for  medical  purposes. 
These  currents  are  first  transformed  from  low  to  high  tension 
by  means  of  a  Rulunkorff's  coil,  the  sparking  capacity  of  which 
need  not  exceed  25  cm.  The  primary  current  is  interrupted  by 
means  of  a  motor-mercury  break,  a  turbine  interrupter,  a 
Jf'elinelfs  apparatus,  which  latter  is  especially  suitable.  The 
alternating  current  which  is  produced  by  the  coil,  and  which  can- 
not be  used  directly,  is  transformed  by  the  condenser  into  a  high- 
frequency  current.  The  condenser  consists  of  two  Franklin's 
plates,  arranged  as  in  Fig.  40  and  placed  within  a  flat  box  (Fig. 
41 ) ,  outside  which  may  be  seen  the  small  solenoid  and  the  spark- 
gap  with  the  connecting  screws.  Or  the  apparatus  may  be  con- 
structed as  shown  in  Fig.  60  e.  Here  two  Leyden  jars  are 
placed  behind  the  spark-gap  (which  is  put  under  a  bell-jar  to 
deaden  the  sound  of  the  discharge;  within  the  bell-jar  a  small 
vessel  containing  soda-lime  is  placed  to  absorb  the  nitrous  fumes. 
From  the  outer  tin-foils  of  the  jars  two  conductors  issue  which 
end  in  two  terminals,  between  which  a  third  is  placed.      Where 


HIGH-FREOUENCY   CURRENTS 


95 


general  d'arsonvalisation  is  required  the  small  and  the  large 
solenoid  are  joined  to  this  terminal. 

The  author  made  his  large  solenoid  as  follows:  A  basket 
wound  round  with  twelve  turnings  of  thick  copper  wire  is  placed 
on  a  long  table.  The  windings  of  copper  wire  are  continued 
through  two  terminals  on  either  side  of  the  table  into  other 
windings  below  the  table  top;  the  two  terminals  of  these  wind- 
ings are  in  connection  with  the  terminals  of  the  condenser 

Oudin's  earlier  resonators  consisted  of  40  to  50  m.  of  cop- 
per wire  one-half  to  3  mm.  in  thickness,  wound  round  an  insu- 
lating cylinder  40  to  50  cm.  in  height  and  30  cm.  in  diameter, 


Fig.  41. — D' ArsonvaV s  apparatus. 

the  distance  between  the  several  spiral  windings  being  i  cm. 
By  means  of  a  terminal  the  conducting  wire  from  one  end  of  a 
d'Arsonval's  solenoid  was  fixed  to  a  suitable  part  of  the  res- 
onator. The  other  end  of  the  solenoid  remained  free  or  was 
earthed.  (Later  on  Oudin  connected  this  with  the  lower  end 
of  the  resonator. )  The  modern  type  of  resonator,  e.  g.,  that  by 
Radiguet,  Ducretet,  Bonetti,  has  the  following  construction 
(Fig.  42)  :  the  inner  tin-foils  of  the  Leyden  jars  are  connected 
with  two  spherical  terminals,  which  can  be  approached  to  or  re- 
moved from  each  other.  The  resonator  proper  consists  of  a 
vertical  cylinder  covered  with  paraffin  wax  and  having  a  spiral 
groove  in  which  the  wire  is  laid.      I'hc  wire  is  2\  mm.  in  thick- 


96 


RADIO-THERAPY 


ness  and  has  50  turnings,  with  a  distance  of  8  mm.  between  each 
turning;  the  whole  length  of  the  wire  amounts  to  45  m. 

The  electrode  is  attached  to  the  upper  end  of  the  wire;  the 
lower  end  is  connected  with  the  outer  tin-foil  of  one  of  the  Ley- 
den  jars,  while  the  outer  tin-foil  of  the  other  jar  is  in  connection 
with  one  of  the  lowest  windings  of  the  resonator,  its  wire  being 
attached  to  a  metallic  ending  which  can  be  moved  up  and  down 
the  resonator  along  a  groove.  Thus  the  resonator  is  divided 
into  two  solenoids. 

We  have  now  to  produce  electrical  oscillations  in  both  sys- 
tems.     The  rate  of  oscillation  depends  on  the  product  of  the 

capacities  and  self-inductions  of 
these  systems,  and  the  arrange- 
ment is  most  effective  if  both  sys- 
tems have  an  equal  rate  of  oscilla- 
tion. The  first  system  consists  of 
the  Ley  den  jars  A^  M  (of  constant 
capacity),  the  outer  tin-foil  of 
which  is  discharged  through  the 
spiral  winding  E  F  (of  variable 
self-induction).     The  second  sys- 

/'    ■ '"■"  '■  " ^    tem  includes  a  conductor  of  vari- 

^^ ^^ able  capacity,  the  body  which  is  to 

be  electrified,  and  a  wire  coil  of 
constant  self-induction.  The  sec- 
ond system  must  allow  of  being 
"tuned"  in  order  to  make  the  prod- 
uct of  its  capacity  and  self-induc- 
tion harmonious  with  that  of  the 
first  (resonance).  This  is  accom- 
plished by  altering  the  number  of 
windings,  i.  e.,  adding  or  taking  away  whole  windings  or  por- 
tions of  them  {Oudin).  Kurdla  ^) ''earths''  the  end  of  the  re- 
mainder of  the  resonance  coil  which  is  not  included  in  the  circuit 
so  that  this  portion  may  not  disturb  the  resonance. 

O.  Roche  fort  devised  a  bi-polar  resonator  (Fig.  43).     He 


Fig.  42. 


^)  VII  Congr.  d.  deutsch.  dermatolog.  Gesellsch.  Breslau,  1901. 
ber.,  p.  488. 


Sitzungs- 


HIGH-FREQUENCY   CURRENTS 


97 


divided  each  of  the  outer  tin-foils  of  his  two  condensers  into 
two  parts  by  connecting  two  of  the  inner  tin-foils  of  4  Leyden 
jais  with  each  other,  and  attaching  to  each  of  these  two  con- 
necting parts  a  metal  rod  ending  in  a  knob  {J  B) .  These  knobs 
placed  opposite  each  other  formed  the  discharger;  the  4  outer 
tin-foils  are  placed  in  the  circuit  at  four  points  F  H  M  L  oi 
two  resonators,  as  shown  in  Fig.  43.  Under  these  conditions 
the  two  resonators,  although  acting  upon  each  other,  are,  elec- 
trically speaking,  separate  and  act  like  two  resonators.  They 
are  worked  by  the  same  interrupter  and  each  gets  an  equal  cur- 

K      in: 


Fig.  43. — Rochcfort's  Bi-polar  Resonator. 

rent,  though  these  run  in  contrary  directions  through  the  pri- 
mary spiral.  According  to  Oiidiu,  the  capacity  of  the  primary 
spiral  F  //  must  correspond  with  that  of  the  secondary  one,  in 
order  that  the  maximum  of  effluvium  may  be  obtained.  The 
secondary  capacity  consists  of  the  capacity  of  the  secondary 
spiral  H  K,  and  that  of  the  whole  conductor  in  connection  with 
the  point  K.  In  order  to  make  these  capacities  agree  the  point 
H  must  be  moved  elsewhere;  both  resonators  require  to  be  regu- 
lated in  this  way. 

The  direction  of  both  effluvia  is  toward  one  another,  not  be- 
cause they  are  of  contrary  electricities,  but  because  the  capacity 
of  one  resonator  attracts  the  effluvium  of  the  other.  When 
equal  effluvia  are  produced  in  both  resonators  by  connecting  the 


98 


RADIO-THERAPY 


wire  which  leads  to  H  with  F,  and  that  which  leads  to  F  with  //, 
the  mutual  repulsion  of  both  effluvia  can  be  easily  seen  in  a  dark 
room ;  this  is  shown  still  more  clearly  in  a  photograph.  By  ar- 
ranging the  apparatus  in  the  way  just  mentioned,  Rochefort  ob- 
tained bi-polar  effluvia  50  cm.  in  length. 

Rcchefort  made  a  bi-polar  resonator  with  two  simple  con- 
densers by  connecting  the  lowest  spirals  of  both  resonators  with 
each  other  (Fig.  44,  M  F)  and  also  the  external  armatures  with 
two  points  near  the  middle  FI  L.  This  arrangement,  however, 
makes  each  resonator  too  dependent  on  the  other;  moreover,  it 


is  difficult  to  regulate  them  when  the  capacities  of  their  secondary 
coils  are  very  different. 

The  electrodes  are  the  same  as  those  employed  in  galvanisa- 
tion and  faradisation,  i.  e.,  plate-electrodes,  knob-electrodes, 
brush-electrodes,  etc.  Oudin's  electrode  is  often  used  for  local 
treatment.  This  consists  of  a  long  ebonite  handle  at  the  end 
of  which  a  thick  metal  rod  is  fixed,  covered  by  a  small  glass 
dome.  The  conducting  wire  is  conveyed  through  a  side  hole 
in  the  handle  to  the  metal  rod. 

Oudin  used  a  very  pliable  material  woven  from  metal  wire, 
such  as  Is  used  for  theatrical  dresses,  as  electrodes,  covering  the 
material  with  moistened  chamois  leather.  By  this  means  he 
was  able  to  spread  the  current  over  a  fairly  large  and  well-con- 


HIGH-FREQUENCY   CURRENTS  99 

ducting  surface,  thereby  preventing  the  patient  from  receiving 
distui-bing  sparking  effects. 

A/.  Kohl  constructed  internal  electrodes  for  use  in  the  body 
cavities.  A  conducting  wire  is  passed  through  small  ebonite 
sticks  of  various  length,  thickness  and  shape,  according  to  the 
cavity  to  which  they  are  to  be  introduced.  The  part  of  the 
body  which  is  to  be  treated  does  not  come  into  direct  contact  with 
the  conducting  wire,  but  serves  in  a  manner  as  a  condenser's 
foil. 

When  the  bi-polar  condenser  is  used  the  patient  holds  in  his 
hand  a  brass  cylinder  connected  with  one  of  the  resonators, 
whilst  the  end  of  the  other  resonator  is  joined  to  the  other  elec- 
trode. In  every  case  the  length  of  the  resonator  must  be  adapted 
to  the  capacity  of  the  electrode  and  that  of  the  patient's  body  if 
perfect  resonance  is  to  be  obtained. 

The  author  has  obtained  considerable  augmentation  of 
power  by  connecting  the  condenser  in  the  following  way :  The 
conductors  from  the  poles  of  the  secondary  coil  of  the  induction 
apparatus  are  led  to  the  inner  tin-foils  of  the  two  Leyden  jars; 
the  outer  tin-foils  of  the  jars  are  connected  with  each  other  as 
well  as  with  one  knob  of  the  spark-gap ;  the  other  knob  being 
connected  with  one  of  the  two  rods  which  lead  to  the  inner  tin- 
foils of  the  jars.  In  this  way  the  spark  is  made  much  brighter 
in  the  spark-gap;  it  is  a  fatter  and  noisier  spark  than  that  pro- 
duced by  the  ordinary  mode  of  connecting  the  two  jars;  more- 
over the  discharges  from  the  resonator,  if  this  be  suitably  ar- 
ranged, are  more  vigorous.  Nevertheless,  by  the  ordinary 
arrangement  a  longer  spark-gap  can  be  traversed. 

When  both  jars  are  connected  in  parallel  the  spark- 
ing becomes  still  more  vivid.  The  two  jars  now  act  like 
a  single  jar  of  double  the  size;  hence  the  quantity  of  the  dis- 
charge is  increased,  whilst  with  the  ordinary  arrangement  one 
obtains  double  the  difference  of  potential  but  only  the  electrical 
quantity  of  a  single  jar;  but  the  discharge  from  the  resonator, 
other  things  being  equal,  is  weaker  in  the  case  of  parallel  con- 
nection of  the  jars.  Parallel  connection  is,  therefore,  not  suit- 
able for  medical  purposes. 

The  effluvium  from  the  resonator  can  be  modified,  firstly,  by 


loo  RADIO-THERAPY 

regulating  the  primary  current  of  the  induction-coil  (by  taking 
resistances  out  of  the  circuit  of  the  rheostat  or  adding  more 
cells  to  the  accumulator;  when  fVehnelt's  interrupter  is  used  the 
same  object  is  attaineci  by  altering  the  length  of  the  anode-pin)  ; 
secondly,  by  altering  the  distance  between  the  knobs  of  the  spark- 
gap,  the  farther  these  knobs  are  apart  the  stronger  the  effect; 
thirdly,  by  regulating  the  resonator;  fourthly,  by  the  use  of  dif- 
ferent electrodes. 

Oiidiu  has  experimentally  proved  that  the  resonator  pro- 
duces greater  electrical  energy  than  electrostatic  apparatus.  The 
intensity  of  high-frequency  currents  was  accurately  measured  by 
d'  Arsonval. 

§  23.  Technique  of  the  Application  of  High-Frequency 

Currents. 

D' Arsonval  distinguishes  between  an  indirect  and  a  direct  ap- 
plication of  the  currents. 

In  the  former  (general  d'arsonvalisation)  either  the  method 
of  auto-conduction  or  of  condensation  may  be  employed. 
In  the  auto-condnction  method  a  large  spiral,  *running  round 
the  patient's  couch,  is  placed  in  the  circuit  from  the  outer  tin- 
foils of  the  condenser ;  the  patient,  fully  dressed,  sits  within  the 
spiral  without  being  in  actual  contact  with  the  conduc- 
tor M  ;  the  patient  is  thus  placed  within  the  electrical  field  and 
totally  charged  with  electricity,  so  that  sparks  can  be  drawn 
from  any  part  of  his  body.  In  the  condensation  method,  the  pa- 
tient is  laid  on  a  couch  made  of  some  badly-conducting  material; 
the  bottom  of  the  couch  is  made  of  metal  and  Is  connected  by  a 
wire  with  one  end  of  the  solenoid  D  (Fig.  40),  while  the  patient 
takes  hold  of  the  second  part  of  the  condenser  (represented  by 
the  couch),  i.  e.,  an  electrode  leading  to  the  other  end  of  the 
solenoid. 


^)  A  solenoid  of  this  description  can  easily  be  arranged  in  a  corner  of 
the  operating-room  by  making  a  door  so  as  to  shut  off  a  triangular  space 
here,  two  sides  of  which  are  made  by  the  walls  of  the  room  and  the  third 
by  the  door.  In  this  space  the  solenoid  is  placed.  The  conducting  wire  runs 
round  the  three  sides  of  the  enclosure,  suitable  contacts  being  made  so  that 
the  circuit  is  closed  when  the  door  is  shut. 


HIGH-FREQUENCY   CURRENTS  loi 

Direct  application  of  high-frequency  currents  is  performed 
as  follows :  The  patient  is  connected  with  one  end  of  the  sole- 
noid D  by  two  metal  plates  on  which  he  places  his  feet,  or  by  a 
foot-bath,  while  the  current  is  closed  by  an  electrode  which  is 
connected  with  the  other  end  of  the  solenoid  and  placed  in  the 
patient's  hand — bi-polar  application.  Local  bi-polar  application 
of  the  currents  is  arranged  by  placing  in  the  patient's  hand  a 
metallic  electrode  which  is  in  connection  with  one  of  the  terminal 
spirals  of  the  small  solenoid,  the  other  terminal  spiral  being 
connected  with  a  second  electrode  which  is  brought  near  the  por- 
tion of  skin  to  be  treated;  or  Oudin's  resonator  may  be  at- 
tached to  one  end  of  the  solenoid  and  a  Oudin's  electrode  con- 
nected with  the  other  end,  and  applied  to  the  skin  as  desired. 

When  the  bi-polar  resonator  is  used  its  discharges  are  ap- 
plied by  connecting  the  end  of  one  coil  with  a  metallic  electrode 
placed  in  the  patient's  hand,  the  efRuvium  from  the  end  of  the 
other  coil  being  directed  toward  the  part  of  the  body  under  treat- 
ment. The  above  directions  are  quite  sufficient  for  auto-conduc- 
tion and  for  condensation;  the  sittings  may  take  place  twice  or 
three  times  a  week  or  daily  for  ten  to  thirty-five  minutes.  The  pa- 
tient must  be  warned  of  the  noise  made  in  the  spark-gap,  lest  he 
be  alarmed;  he  must  also  be  very  careful  not  to  touch  any  part 
of  the  apparatus  which  is  not  given  into  his  hands  by  the  opera- 
tor; otherwise  he  runs  the  risk  of  receiving  shocks. 

One  proceeds  differently  with  the  application  of  high-fre- 
quency currents  according  to  the  condition  of  the  disease  under 
treatment.  When,  for  example,  the  electrolytic  effect  of  the 
current  is  especially  called  for,  the  proper  electrode  should  be 
rapidly  approached  to  the  skin  and  pressed  tightly  upon  it  so 
as  to  spare  the  patient  any  disagreeable  sensation  (see  Hg.  60). 
Then  according  to  requirements  the  electrode  is  left  for  a  longer 
time  in  situ  (c.  »;.,  at  the  tender  spots  in  the  case  of  sciatica) 
till  a  lively  sensation  of  warmth  is  felt;  or  the  electrode  may  be 
slowly  and  with  some  pressure  passed  along  the  course  of  the 
nerve  trunks;  the  latter  may  be  accomplished  either  with  the 
point  of  the  electrode  or  with  the  latter  so  held  that  it  covers  a 
greater  surface.  When,  however,  the  mechanical  effect  of  the 
discharges  is  required  the  electrode  is  kept  at  some  slight  dis- 


104 


RADIO-THERAPY 


tance  from  the  skin;  a  bright  brush  of  sparks  then  plays  upon 
the  skin  from  the  electrode  followed  by  a  distinct  sensation  of 
warmth  and  pricking.  The  explanation  of  this  phenomenon  is 
as  follows :  When  the  electrode  is  in  close  contact  with  the  skin, 
the  resistance  to  the  passage  of  the  current  is  very  weak;  with 
the  electrode  at  some  distance  from  the  skin,  however,  the  re- 
sistance is  much  increased,  for  the  current  has  to  traverse  the 
air,  which  is  a  bad  conductor.^)  According  to  the  formula  J-R 
(p.  41),  the  degree  of  heating  depends  upon  the  resistance. 
Much  of  the  effect  depends  upon  the  kind  of  electrode  employed. 
(The  reader  is  referred  to  the  different  ways  in  which  the  dis- 
charge can  be  increased  by  altering  the  modes  of  connection, 
p.  98.)  When  using  Oiidin's  electrode  there  is  an  appearance  of 
violet  light  radiating  toward  the  skin  from  the  most  adjacent 
point  of  the  electrode.  This  luminous  aigrette  is  seen  on  care- 
ful inspection  to  be  composed  of  an  infinity  of  fine,  shining 
sparks;  part  of  these  would  seem  to  penetrate  the  glass  wall, 
part  are  absorbed  by  it.  Small  sparks  issue  in  much  smaller 
number  from  the  outside  of  the  glass  covering  of  the  electrode 
when  the  latter  is  kept  at  not  too  great  a  distance  from  the  skin; 
the  effect  caused  by  these  sparks  is  quite  insignificant. 

The  fact  that  the  sparks  actually  penetrate  the  glass 
covering,  especially  if  the  latter  be  thin,  is  proved  by 
the  presence  of  minute  fissures  in  the  glass  after  some 
considerable  wear.  These  fissures  are  found  to  lie  in 
the  line  of  passage  of  the  sparks.  To  some  extent  a 
condensing  power  exists  in  the  glass  case  which  may  be 
conceived  as  acting  like  that  of  a  Leyden  jar. 

The  spark  discharge  from  the  metallic  terminal  of 
the  electrode  to  its  glass  covering  becomes  more  power- 


^)   According  to  Lord  Kelvin — 
A  spark-gap  of  0.5    mm.  corresponds  to  a  tension-difference  of     2.910  volts. 


•3 
.6 

■  15 
.20 


4.830 
11.460 
20.470 
29.340 
31-350 


The  above  figures  indicate  the  high  resistance  of  the  air,  which  can  only 
be  overcome  by  high  tensions. 


HIGH-FREQUENCY   CURRENTS  103 

ful  the  nearer  the  apparatus  is  placed  to  the  skin  and  the 
moister  the  state  of  the  latter.       Since  the  treatment 
usually  causes  a  slight  perspiration  at  the  parts  treated, 
the  apparatus  works  more  effectively  toward  the  end  of 
the  sitting. 
With  the  glass  covering  removed  there  is  no  diminution  in 
the  intensity  of  the  discharges;  the  sparks  now  strike  the  skin 
with  undiminished  vigour.      Used  In  this  way,  the  apparatus  is 
more  powerful  and  decidedly  more  effective,  and  it  may  be  rec- 
ommended In  this  form  for  the  treatment  of  skin  disease. 

Still  more  vigorous  effects  will  be  obtained  by  arming  the 
ends  of  the  wire  from  the  resonator  with  a  faradic  brush.  This 
gives  one  an  apparatus  which  Is  very  useful  for  local  stimulating 
purposes. 

When  the  electrodes  are  kept  at  some  distance  from  the  skin, 
a  spark-brushing  Is  produceci  which  may  be  compared  to  that 
obtained  from  monopolar  discharges  from  Induction  coils  (see 
below),  though  the  effect  Is  weaker. 

The  patient's  body  may  be  charged  with  high-tension  elec- 
tricity by  placing  a  metallic  electrode  In  his  hand;  the  operator 
then  massages  the  diseased  part  with  his  bare  hand,  drawing 
sparks  from  the  patient's  skin  in  the  process;  but  the  electric  cur- 
rent Is  much  more  effective  when  locally  applied  than  when  used 
in  this  manner  because  of  the  strong  resistance  offered  by  the 
body.  Another  variation  consists  in  the  operator  holding  the 
electrode  In  one  hand  while  he  passes  the  other  hand  over  the 
affected  region  of  the  patient. 

Local  d'arsonvahsation  is  best  applied  daily  from  10  to  15 
minutes;  the  appearance  of  a  red-brown  colour  on  the  skin  is 
an  Indication  for  stopping  the  treatment  until  the  part  resumes 
Its  normal  appearance.  For  the  local  treatment  of  the  head 
or  face  the  patient  Is  best  seated  In  a  revolving  chair  having 
an  adjustable  head-rest.  Care  must  be  taken  that  the  wire 
leading  from  the  apparatus  to  the  electrode  does  not  come  in 
contact  with  the  patient;  care  must  also  be  taken  that  sparks  are 
not  too  long  applied  to  a  small  area  of  skin,  otherwise  blisters 
and  sores  may  develop. 


104  RADIO-THERAPY 

§  24.  Physiological  Effects  of  High-Frequency   Currents. 

High-frequency  currents  are  not  injurious  to  the  human 
organism ;  they  traverse  it  with  an  intensity  and  tension  sufficient 
to  light  an  incandescent  lamp,  without  causing  the  least  sensa- 
tion. D'Arsonval^)  showed  that  neither  muscles  nor  the  periph- 
eral ends  of  sensory  nerves  are  impressed  by  these  extraordinarily 
rapid  oscillations;  on  the  contrary  tissues,  especially  epidermis 
and  denuded  nerve  endings  through  which  high-frequency  cur- 
rents have  passed,  are  said  to  become  less  sensitive  to  normal 
stimuli.  Thus  an  anaesthesia  lasting  from  5  to  20  minutes 
may  result,  though  it  does  not  penetrate  very  deeply.  In  the  au- 
thor's experience  the  ansesthesia  produced  by  high-frequency  cur- 
rents is  very  insignificant,  though  he  would  by  no  means  call  into 
question  d'Arsonval's  opinion  on  this  point.  Probably,  as  be- 
fore suggested,  the  different  results  obtained  by  these  most  able 
French  physiologists  are  to  be  explained  by  differences  in  the 
arrangement  of  their  apparatus.  Dotimer  and  Oudin  believed 
that  the  anaesthesia  described  by  d'Arsonval  and  recommended 
by  him  for  surgical  operations  is  the  first  stage  toward  cell- 
death,  which  is  quite  analogous  to  the  ansesthesia  caused  by 
freezing.^) 

Baedaeker,  on  the  other  hand,  states  that  hyperaesthesia  is 
induced  by  high-frequency  currents. 

D'Arsonval  propounds  two  theories  with  the  view  of  ex- 
plaining the  remarkable  phenomenon  that  sensory  nerves  are  not 
affected  by  high-frequency  currents. 

1st.  The  currents  do  not  act  on  the  organism,  because  they 
only  spread  throughout  its  surface,  or, 

2nd,  The  peripheral  nerves  are  only  sensitive  to  electric 
vibrations  of  low-frequency;  just  as  the  terminals  of  the  acoustic 
and  optic  nerves  will  remain  unaffected  by  ether  vibrations  which 
are  above  or  below  certain  limits. 

Against  the  first  theory  we  may  urge  the  fact  that  sinusoidal 
currents"),  without  causing  any  marked  sensation,  have  some  in- 


^)   Ann.  d'electrobiologie,  Vol.  I,  No.  i. 
")   Ibid.  1900,  Vol.  Ill,  p.  513. 

^)   These  are  alternating  currents,   consisting  of  gradually  increasing  and 
decreasing   waves.     They  are  produced   by  means   of   suitable   transformers 


HIGH-FREQUENCY   CURRENTS  105 

fluence  on  tissue-nutrition;  they  must,  therefore,  be  penetrative 
to  some  degree. 

Vittorio  MaragUmw  ')  states  that  the  heat  effects  which  are 
produced  by  high-frequency  currents,  after  they  have  traversed 
a  considerable  depth  of  living  or  dead  tissue,  prove  that  d' Ar- 
sonvafs  currents  take  not  only  a  superficial  course,  but  also  pene- 
trate more  deeply. 

L.  Hooriicg^  -)  is  also  of  opinion  that  d'Arsojival's  high-fre- 
quency currents  do  not  remain  on  the  surface  of  the  hu- 
man body,  but  penetrate  it  completely;  this  is  also  shown  by  the 
results  of  Einlhofoi' s  and  Leydcu's  experiments. 

In  the  author's  opinion  even  d' Arsouval's  second  theory  is 
unnecessary.  When  a  primary  current  in  a  Faraday's  induc- 
tion-apparatus is  very  rapidly  interrupteci  by  means  of  a  motor- 
break  violent  muscular  contraction  can  be  evoked  without  the 
least  sensation  of  electricity  on  the  part  of  the  patient  {d'Arson- 
val) .  In  this  case  a  current  of  definite  intensity  and  tension 
induces  a  certain  number  of  alternating  currents  of  likewise  defi- 
nite qualities.  When  we  diminish  the  rate  of  interruption  with- 
out interfering  with  the  primary  current,  the  tension  at  the  poles 
of  the  secondary  coil  becomes  raised,  i.  e.,  the  induced  current 
has  (the  resistance  not  having  been  interfered  with)  a  greater 
intensity  than  before.  The  author's  bacteriological  experiments 
have  proved  (see  later)  that  with  a  higher  current-intensity 
more  powerful  effects  are  obtained.  We  are,  therefore,  enti- 
tled to  expect  that  a  reduction  in  the  rate  of  interruption  of 
the  primary  current  is  followed  by  an  increased  intensity  of  the 
secondary  current,  and  in  consequence  of  that  more  marked  phys- 
iological effects,  e.  g.,  sensation.  This,  indeed,  is  the  case. 
We  may  reasonably  suppose  the  same  to  obtain  in  the  case  of 
high-frequency  currents;  by  reason  of  the  rapid  alternations  the 
intensity  of  any  single  shock  may  conceivably  be  very  insignifi- 
cant. On  the  other  hand,  we  may  expect  that  by  raising  the  in- 
tensity of  high-frequency  currents  (by  suitable  windings  of  the 


which   regulate   and   reduce   the   intensity   and   tension   of   currents    from    tlie 
main   (alternating  or  rotary). 

')   Clinica  medica,   igoi.  No.  7. 

')  Pmigcr's  Archiv.,  Vol.  LXXXIII,  8. 


io6  RADIO-THERAPY 

coils  and  construction  of  the  condensers)  the  physiological  effects 
will  become  much  more  marked. 

In  the  low  intensity  of  these  currents  may  lie,  therefore,  the 
explanation  of  the  remarkable  fact  that  they  produce  so  trifling 
a  sensation.  We  must,  however,  distinguish  between  the  effects 
of  the  electric  current  anci  that  of  the  electric  discharges  on  the 
sensory  nerves.  The  latter  produce  the  same  sensations  in  the 
case  of  high-frequency  currents  as  do  the  discharges  of  any 
other  kind  of  static  electricity.  Again,  we  must  not  associate 
the  two  facts  that  on  the  one  hand  high-frequency  currents  cause 
no  sensation,  while  on  the  other  hand  they  are  said  to  produce 
analgesia. 

H.  Kurella^)  noted  that  when  the  resonator  to  which  the 
electrode  is  attached  is  only  connected  in  a  uni-polar  manner  with 
the  solenoid  D,  d'Arsoiival's  current  evokes  a  marked  sensation 
of  formication  and  a  tetanising  effect  in  the  muscles;  the  latter 
does  not  take  place  in  the  case  of  bi-polar  connection. 

D' Arsonval  infers  from  his  experiments  that  high-frequency 
currents  have  a  great  influence  on  metabolism  and  cell-produc- 
tion. By  their  action  respiratory  combustion  is  intensified,  the 
quantity  of  oxygen  consumed  in  the  unit  of  time  as  well  as  that 
of  carbonic  acid  eliminated  is  heightened.  In  one  instance  an 
increase  took  place  in  the  latter  of  from  17  to  37  litres.  This 
augmentation  of  the  process  of  combustion  is  also  indicated  by 
the  increase  in  the  amount  of  urea  excreted,  while  that  of  uric 
acid  is  diminished  {Lazat  and  Gaiitier) .  At  the  same  time 
the  body  parts  with  more  heat;  nevertheless,  despite  this  aug- 
mentation in  the  process  of  combustion  the  body  temperature  is 
scarcely  raised,  but  a  further  proof  of  heightened  combustion 
was  furnished  by  the  loss  of  weight  of  the  animals  used  in  these 
experiments.  A  little  guinea-pig,  for  instance,  lost  under  ordi- 
nary conditions  6  grammes  in  weight  in  sixteen  hours;  when  ex- 
posed to  the  action  of  high-frequency  currents  it  lost  30  grammes 
in  the  same  time.  After  that  when  left  to  itself  it  recovered  the 
lost  weight  in  2  hours. 

Berlioz  ')  tested  the  urine  of  280  patients  who  were  under 


^)   Zeitschr.  f.  Elektrotherapic  und  arztl.  Elektrotech.,  1900,  p.  59. 
'^)   Compt.  rend  de  I'Academie  des  Sc,  March  18,  1895. 


HIGH-FREQUENCY  CURRENTS  107 

treatment  by  auto-conduction,  examining  in  all  761  specimens. 
He  found,  first,  increased  diuresis  and  better  elimination  of  the 
excreta;  secondly,  increased  organic  combustion;  thirdly,  the 
proportion  between  uric  acid  and  urea  approached  nearer  the 
normal  ( i  :  40).  Apostoli  observed  with  his  patients  increased 
diuresis  and  excretion  of  urea,  increase  in  the  percentage  of  oxy- 
hzemoglobln  in  the  blood,  better  capacity  for  work  and  walk- 
ing, etc.  HcTmospectroscopic  analysis  by  Henocque's  method 
shows  the  vigorous  effects  of  these  currents  on  nutrition  change. 
The  process  of  nutrition  is  both  stimulated  and  regulated. 

Tripet  ^)  made  researches  on  the  influence  of  high-frequency 
currents  on  the  reducing  power  of  oxyhaemoglobln.  He  found 
this  power  Increased  In  37  cases  of  patients  suffering  from  de- 
fective metabolism  ("rheumatism"). 

In  10  cases  of  diabetes  where  the  reducing  power  was  much 
augmented  before  treatment  it  became  lowered  by  high-fre- 
quency currents.  In  6  cases  marked  bygeneral  organic  decay  the 
treatment  was  unsuccessful.  Guillaume  '-)  also  pursued  investi- 
gations on  the  lines  of  Tripet.  His  patients  were  affected  with 
arthrodynia,  sciatica,  chlorosis;  In  them  the  quantity  of  oxy- 
h<TmoglobIn  was  increased  together  with  its  reducing  power; 
often,  too,  the  general  health  became  improved.  This  Improve- 
ment, however,  was  partly  due  to  the  modified  nutrition,  as  was 
shown  by  the  analysis  of  the  blood  and  urine.  In  any  case  the 
good  effects  cannot  be  ascribed  to  the  high-frequency  currents 
alone.  The  Inhalation  of  ozone  acts  in  the  same  way  on  hzemo- 
gl'obin  {Labbe),  and  It  is  well  known  that  high-frequency  cur- 
rents arc  always  accompanied  by  the  production  of  ozone. 

Lacaille'")  found  that  In  his  cases  the  quantity  of  urea  ex- 
creted while  the  patients  were  under  the  Influence  of  auto-con- 
duction increased  from  1 1  grammes  to  43,  and  even  60  grammes. 

Denoyes,  Martre  and  Rouviere  ^)  found  that  under  the  influ- 
ence of  high-frequency  currents  the  daily  quantity  of  urine  ex- 
creted Increased  In  the  same  proportion  as  did  the  urea,  uric  acid, 


,*)  Acad.  d.  Sc,  June  25,  igoo. 
^)   Gazette  des  Hopitaiix,  February  7,  1901. 
')  Bullet,  offic.  d.  1.  Societe  fr.  d  electrotherapie,  March,   1900. 
*)  Compt.  rend  de  I'Acad.  d.  Sc,  July  i,  1901. 


io8  RADIO-THERAPY 

nitrogen,  phosphates,  sulphates  and  chlorides.  The  increase 
varies  with  different  people,  and  is  maintained  to  some  extent 
for  3  days  after  suspending  treatment. 

G.  S.  Vina'i  and  G.  Victti'^)  also  found  in  two  cases  that 
d'arsonvalisation  increases  the  total  amount  of  nitrogen  and 
phosphates  excreted. 

These  statements  of  d'Arsonval  and  his  pupils  have,  how- 
ever, not  been  generally  confirmed. 

Giiilloz  enquired  into  the  tissue  change  in  muscles,  and  could 
not  observe  any  increase  in  the  assimilation  of  oxygen  brought 
about  by  auto-conduction.  He  does  not,  however,  doubt  the 
results  of  d'Arsonval's  enquiries,  which  indicated  an  increased 
assimilation  of  oxygen  in  the  body,  but  maintains  that  this  in- 
crease cannot  be  due  to  increased  oxygenation  in  the  protoplasm. 

L.  Oucrton  -)  found  not  the  slightest  increase  in  the  output 
of  carbonic  acid  by  the  use  of  alternating  currents  of  high-fre- 
quency and  tension. 

Reale,  Renzi  and  Final  ^)  were  of  opinion  that  Tesla's  cur- 
rents considerably  increased  the  oxygenation  of  the  bociy  by  pro- 
moting the  elimination  of  uric  and  phosphoric  acid. 

Querton'')  observes  that  d'Arsonval  does  not  mention  if  the 
guinea-pigs  employed  in  his  experiments  were  fed  during  the 
process,  or  if  the  temperature  remained  normal. 

/.  E.  Baedeker  *)  reports  that  rabbits  which  were  subjected 
to  the  auto-conduction  method  showed  an  increase  in  the  rate 
and  depth  of  respiration,  and  along  with  that  an  increase  in 
respiration-quantity  (from  6,140  to  1 1,000  c.cm.).  This  effect 
was  maintained  for  five  minutes  after  the  operation,  but  gave 
way  after  fifteen  minutes  to  normal  conditions.  In  the  case  of 
other  animals  the  respiration  was  in  no  way  affected. 

A .  Loizvy  and  T.  Cohn  ^)  made  experiments  on  the  respira- 
tion of  eight  persons.  They  found  "in  one  case  an  increased 
consumption  of  oxygen,  which  exceeded  the  normal  physiological 


^)  Giorn.  d.  elettr.  medic,  i,  2,  p.  61. 

")  Ann.   d'electrobiologic.  Vol.   Ill,  p.   14. 

^)  Institut  Solvny,    1899. 

')  Wiener  Klinik,  Vol.  XXVII.  No.s.  10  and  11. 

°)  Berlin,  klin.  Woch.,  1900,  No.  34. 


HIGH-FREQUENCY  CURRENTS  109 

limits  of  6  per  cent,  by  12.6  per  cent.,  in  another  case  by  19  per 
cent." 

N.  Spiisski')^  on  the  contrary,  found  a  decreased  assimila- 
tion of  oxygen  and  of  carbonic  acid  and  a  decrease  in  the  ex- 
halation of  aqueous  vapour  in  animals  which  underwent  general 
d'arsonxalisation;  he  therefore  denies  any  effect  on  the  inter- 
change of  gases  by  this  proceeding. 

I'he  third  important  property  ascribed  by  d'Jrsomuil  to 
high-frequency  currents  is  their  iiiHuence  on  the  vaso-motor  sys- 
tem. When  a  rabbit  is  subjected  to  the  currents  it  will  be  ob- 
served that  the  vessels  on  the  animal's  ear  rapidly  dilate,  just  as 
they  do  after  section  of  the  sympathetic  nerve.  This  phenome- 
non is  succeeded  by  marked  contraction  of  the  vessels.  The 
blood  pressure  of  a  person  undergoing  general  d'arsonvalisa- 
tion,  as  shown  by  the  sphygmograph  or  sphygmomanometer  is 
seen  first  to  fall  and  to  rapidly  rise.  The  same  thing  is  shown 
by  a  mercury  pressure  gauge  brought  into  contact  with  an  artery. 
D'Arsouval  observed  that  the  blood  issuing  from  an  incision  in 
a  rabbit's  foot  flowed  more  freely  after  the  action  of  high-fre- 
quency currents. 

But  these  statements  of  d' Arsonval  are  also  not  generally 
confirmed. 

Carvalho  found  no  change  in  the  blood  pressure  after  auto- 
conduction,  neither  could  he  observe  any  motor  or  sensory  reac- 
tion. But  when  a  very  strong  current  was  ciirectly  applied  to 
the  skin  the  sensibility  of  the  latter  became  affected,  and  at  the 
same  time  the  blood  pressure  decreased.  He  obtained  the  same 
motor  and  sensory  reactions  with  muscle-nerve  preparations 
from  frogs  as  are  to  be  obtained  from  other  kinds  of  currents. 

Moittier'-)  states  that  he  decreased  arterial  pressure  by 
means  of  auto-conduction,  which  is  precisely  the  opposite  of 
d' ArsonvaV s  finding  ■') .  The  same  author, ")  however,  produced 
an  increased  arterial  pressure  of  2  to  3  cm.  by  applying  the 
effluvium  from  the  resonator  along  the  spinal  column. 


')  Lc  Physiolopjistc  Russc,  Moscow.   iSgrj;  quoted  hy  liardcL'Cr. 

')  Soc.  medic. -chirurg.,  l)c-ccnd)cr  ii.  i.Syf). 

')  Bulletin  offic.  dc  la  Soc.  fr.  d'elcclrothcrapie,  uSqj. 


no  RADIO-THERAPY 

Lediic^)  found  that  high-frequency  currents  induce  cutis 
anserina  and  superficial  anaemia,  which  is  necessarily  followed 
by  an  increase  in  the  general  arterial  pressure. 

Oudin  -)  raised  the  arterial  pressure  of  anaemic  patients 
from  9  to  14  cm.  in  one  sitting  under  the  effluvium  of  the  reso- 
nator; he  examined  the  capillary  pulse  by  Laiilanie  s  sphyg- 
mometer, and  found  that  whenever  the  effluvium  of  the  resona- 
tor played  on  the  region  of  the  body  the  capillary  vessels  at  once 
spasmodically  contracted,  thereby  effecting  a  fall  in  the  curve; 
after  suspending  operations  the  pulse  resumed  Its  previous  char- 
acter, but  it  was  some  time  before  It  recovered  its  previous 
amplitude. 

Doinner  and  Oiidin,  therefore,  recommencied  this  treatment 
for  affections  due  to  deficient  tissue  change  and  for  local  inflam- 
mations accompanied  by  arterial  or  venous  stasis. 

Baedeker'')  re-examined  all  d'Arsonvcil's  statements  as  to 
the  effect  of  high-frequency  currents  on  the  blood  pressure.  He 
found  that  general  d'arsonvalisation  effected  an  increase  of  the 
"extinction-pressure"  amounting  to  6  cm.  and  more;  this  could 
be  observed  on  the  human  body  by  means  of  F.  Basclis  sphyg- 
momanometer; with  rabbits,  however,  he  could  not  confirm  the 
appearance  of  the  phenomenon  of  the  ear-vessels,  or  of  the 
blood-flow  from  an  incised  foot,  or  any  increase  In  the  blood- 
pressure  of  the  carotids. 

Experiments  by  Locivy  and  T.  Colin  yielded  quite  negative 
results. 

According  to  Caferena,^)  high-frequency  currents  have  a 
distinct  effect  on  gastric  peristalsis,  especially  in  cases  of  atony 
of  that  organ. 

Another  property  ascribed  to  high-frequency  currents  is 
their  effect  on  microbes  and  their  toxins.  D'Arsonval  and  Char- 
rin  ^)  tested  their  bactericidal  effects  on  the  organisms  found 
in  the  dregs  of  beer  and  on  bacillus  pyocyaneus.      D'Arsonval 


^)  Quoted  by  Doiimcr-Oudin. 

')  Ann.  d'electrobiologie.   1900,  Vol.  Ill,  p.  314. 

')  Wiener  Klinik,  Vol.  XXVII,  Nos.  10  and  il. 

*)  Clinica  medica,  1901,  No.  7. 

'')  Academic  d.  Sc,  Feb.  10,  1896. 


HIGH-FREQUENCY   CURRENTS  iii 

also  found  that  toxins  can  be  powerfully  modiHed  in  their  viru- 
lence and  converted  into  anti-toxins.^) 

D'Jrsonviil's  arrangement  for  the  experiment  was 
as  follows :   The  liquid  to  be  dealt  wnth  was  placed  in  a 
U-tube,  in  both  arms  of  which  platinum  pins  were  im- 
mersed, which  were  in  connection  with  the  ends  of  the 
solenoid.      The  U-tube  was  surrounded  by  a  cooling  ap- 
paratus. 
D'Arsonval  and  Phisalix  -)   found  also  that  the  venom  of 
serpents  (viper,  cobra)  also  loses  its  poisonous  properties  after 
exposure   to   high-frequency   currents.      Bojwme   and   Viola  -) 
achieved  still  greater  success  in  this  direction,  and  state  that 
their  method  proves  an  effective  antidote  against  even   diph- 
theria. 

Haller")  observed  a  similar  destructive  effect  on  algae, 
fungi,  and  bacteria  when  he  allowed  the  currents  to  traverse  a 
liquid  in  which  these  organisms  were  suspended.  Dubois,  of 
Rheims,-')  confirmed  d' ArsonvaV s  statements  as  to  the  lessen- 
ing of  the  virulence  of  toxins ;  he  was  not,  however,  able  to  pro- 
duce anti-toxins  by  the  process. 

The  literature  of  the  subject  is  marked  by  the  most  diverse 
opinion  on  this  point.  Oiidin  and  Doumer;^)  for  instance,  could 
find  not  the  least  effect  from  the  resonator  discharge  on  the 
arresting  of  organic  development. 

Discharges  from  the  resonator  cause,  when  applied  to  the 
surface  of  the  skin,  first,  marked  anaemia  and  cutis  anserina. 
1  his  condition  continues  for  one  or  two  minutes,  and  is  com- 
bined with  a  considerable  sensation  of  burning  and  smarting. 
The  an.Tmia  afterwards  gives  way  to  a  fairly  marked  erythema; 
this  erythema  may  last  according  to  the  intensity  and  duration 
of  the  operation,  also  to  the  patient's  capacity  for  reaction,  for 
several  hours  or  even  for  two  days.  Oudin  observed  the  ap- 
pearance of  blisters  after  a  protracted  local  application  of  the 
currents. 


')    Societc  (k-  biologic,   1896. 

^)  Quoted  by  Doumcr-Oudin,  Annalcs  d'elcctrobiologie,  Vol.  Ill,  p.  517. 

')  Ibid. 


112  RADIO-THERAPY 

The  author  observed  a  case  of  this  kind  in  a  lady 
who  had  a  very  sensitive  and  tender  skin.      Powerful  dis- 
charges from  the  bare  metal  electrode  were  thrown  onto 
the  knuckles  (where  the  cuticle  is  highly  stretched  and 
the  bones  are  lying  near  the  surface).       Small  bulls, 
half  the  size  of  a  pea,  made  their  appearance,  surrounded 
by  normal  skin.      On  the  following  day  the  bulla;  had 
dried    up    and    the    skin    soon    became    quite    normal. 
A/.  Bisscric  told  the  author  that  excessive  application  of 
high-frequency  currents  may  induce  actual  destruction  of 
tissue,  as  do  the  Roentgen  rays. 
Very  often  small  beads  of  perspiration  make  their  appear- 
ance on  the  part  treated,   accompanied  by  some  considerable 
cedema.      After  the  repeated  application  of  spark-discharges  a 
brownish   discolouration   often   persists   in   the  skin;   this   is  a 
haemoglobin  stain. 

Arguing  from  the  circumstance  that  in  d' ArsonvaV s  appa- 
ratus electrical  vibrations  are  produced  which  can  be  focussed 
on  definite  parts  of  the  body  by  means  of  Oudin's  resonator, 
we  might  fairly  look  upon  the  treatment  of  skin  diseases  by 
means  of  d' Arsonval-Oudin  s  apparatus  as  a  branch  of  radio- 
therapeutics;  but  from  the  author's  experiments  he  cannot  look 
upon  the  physiological,  biological  and  therapeutic  effects  of  the 
method,  so  far  as  they  concern  the  skin,  as  being  due  to  electric 
vibrations.  He  believes,  on  the  contrary,  that  the  sparking 
which  accompanies  these  vibrations  is  the  most  active  factor, 
and  he  believes  that  the  effects  of  spark-discharges  from  d' Ar- 
sonval-Oudin's  apparatus  only  differ  in  degree  from  those 
which  are  produced  by  other  generators  of  high-tension  elec- 
tricity. When  an  experiment  was  arranged  in  such  a  way  as 
to  prevent  the  impact  of  the  spark-discharge  on  the  exposed 
object  without  hindering  the  progress  of  the  electric  vibrations 
{e.  g.,  by  a  thick  wooden  board),  results  were  entirely  nega- 
tive. 

Negative  results,  moreover,  were  obtained  from  experi- 
ments as  to  the  final  effect  of  the  dynamic  electricity  emitted  by 
Oudin's  apparatus. 

The  phenomena  which  d'Arsonval  observed  in  the  case  of 


HIGH-FREQUENCY  CURRENTS  113 

a  living  being  enclosed  within  his  solenoid  and  described  by 
him,  may  be  looked  upon  as  the  effects  of  "influence,"  or  of 
electrical  vibrations  produced  by  the  apparatus.  These  phe- 
nomena bear  some  relation  to  the  biological  effects  of  other 
radiations,  and  we  may  fairly  characterise  this  method  as  a 
branch  of  radio-therapy. 

We  must  make  the  following  distinctions  in  the  biological 
effects  of  the  discharge  from  d\J rsoizcil-Oiidiii' s  apparatus: 

First,  the  direct  effects  of  the  electrical  {i.  c,  of  the  dy- 
namic electricity)  and  those  of  the  electrical  vibrations  on  the 
internal  organs. 

Second,  the  effects  which  are  partly  the  direct  and  partly 
the  indirect  consequence  of  the  changes  brought  about  on  the 
body-surface  by  the  static  discharge;  the  latter  effects  are  shown 
by  modifications  in  the  functions  of  the  internal  organs. 

There  is  a  wide  province  for  future  work  on  the  first-men- 
tioned group,  but  little  being  at  present  definitely  known  on  the 
subject.  Some  experiments,  however,  which  the  author  under- 
took in  the  year  1900  under  the  direction  of  Prof.  Anton  JVeich- 
selbmim  in  the  Patho-Anatomical  Institute  of  Vienna,  throw 
some  light  on  the  manner  of  the  local  action  of  discharges  from 
high-tension   and   rapidly-alternating  currents. 

At  the  same  time  the  effects  of  the  discharges  from  a  Rii/nn- 
korfs  coil  were  also  carefully  studied,  the  author  believing,  as 
he  did,  that  In  the  treatment  by  every  kind  of  high-tension 
electricity  (faradisation,  franklinisation,  high-frequency  cur- 
rents) we  are  dealing  with  the  effects  of  one  and  the  same 
physical  phenomenon,  /.  e.,  with  spark-discharges. 

The  sparking  is  more  mtense  according  to  the  height  of 
the  tension,  more  brilliant  according  to  the  quantity  of  electric- 
ity. Sparks  are  emitted  from  the  poles  of  an  electro-static  ma- 
chine or  from  those  of  Faraday's,  Rithmkorfs  or  d'Arsonval's 
apparatus  when  the  machine  is  brought  near  the  human  body; 
these  sparks  only  differ  from  each  other  in  their  shape,  intensity, 
length  and  the  rate  at  which  they  succeed  each  other.  By 
means  of  suitable  contrivances  the  sparks  from  all  these  appara- 
tus can  be  changed  into  quiet  discharges,  in  which  the  high-ten- 
sion electricity  flows  off  as  "electrical  wind." 


114  RADIO-THERAPY 

Faradic  discharges  onto  the  skin  produce  cHnically  shght 
pain,  hypercemia  and  erythema,  the  latter  varying  with  the  in- 
tensity of  the  discharge;  also  some  degree  of  cutis  anserina. 
The  sensitiveness  of  the  skin  is  much  increased  and  the  feeling 
of  pain  diminished.  The  circulation  in  remoter  organs  is 
markedly  influenced.  Thus,  for  instance,  it  is  possible  to  pro- 
duce cerebral  anemia  even  to  the  stage  of  syncope  by  faradisa- 
tion of  the  abdomen (  V.  Basch).  By  reflex  action,  moreover, 
vaso-motor,  sensory  and  motor  nerves,  glands  and  other  organs 
containing  involuntary  muscle  fibre  can  be  excited.  Organs 
which  are  deeply  situated  can  be  relieved  of  congestion  by  pro- 
ducing hyperaemia  of  the  cuticle.  According  to  Beard  and 
Rockwell,  this  method  of  electrisation  acts  not  only  as  a  stimu- 
lant, but  also  as  a  very  effective  tonic  alterative  and  sedative 
(Leivandowsky) ,  especially  in  various  conditions  of  asthenia 
and  disturbances  due  to  malnutrition  (anaemia,  chlorosis, 
rheumatism).  Spilker  and  Goldstein  stated  that  induced  elec- 
tricity was  also  capable  of  destroying  bacteria.  This  statement 
has  since  been  disputed. 

Local  faradisation  gives  similar  results,  especially  as  re- 
gards local  effects.  Discharges  of  static  electricity  produce 
first  anaemia,  the  duration  of  which  depends  upon  the  intensity 
of  the  discharge;  this  anemia  is  afterwards  replaced  by  a  cor- 
respondingly enduring  hyperaemia.  The  effects  of  the  spark 
discharge  can,  moreover,  be  considerably  increased,  being  then 
associated  with  marked  feeling  of  pain,  the  appearance  of 
papules,  vesicles,  and  even  large  blisters.  When  acting  on  the 
whole  organism  this  method  increases  the  pulse  rate,^)  the  ex- 
cretion of  sweat,  saliva,  and  urine,')  causes  even  an  increase  in 
the  body  temperature,^)  facial  erythema,  and  an  exciting  or 
sedative  effect  on  the  nerves.  Vigouroux^)  maintained  that 
franklinisation  powerfully  stimulates  the  process  of  nutrition; 
he  therefore  urged  Its  employment  in  those  diseases  associated 


^)   Cavalho  and    JVilkinson.    Traite    complet.    d'electricite,    1777-1785. 
")   Mauduyt,   Article   "Electricity"    in    the    i8th    Century   Encyclopedia. 
')  Sigaud  de  la  Fond. — De  I'electricite  medicale   1771,   and  Journal   de 
medicine  de  Vandermond,  Vol?.  LXX  and  LXXII. 
*)    Vigour oux.  Gazette  medicale,  1878. 


HIGH-FREQUENCY   CURRENTS  115 

with  defective  metabolism.  Further  defects  are  said  to  be  reg- 
ulation of  the  catamenia,  improvement  of  the  appetite,  so- 
porific, anti-spasmodic,  and  anodyne  effects,  Destot  and  Du- 
bard  maintained  that  this  kind  of  electricity  possessed  bacteri- 
cidal properties. 

Before  proceeding  to  a  description  of  the  author's  own  ex- 
periments, some  remarks  may  not  be  out  of  place  here  concern- 
ing the  different  kinds  of  electric  sparks.  -Ihe  following  ob- 
servations are  in  part  quoted  from  the  classical  work  of  Bou- 
chacocrt  and  Re  dm  and  ^)  on  this  subject. 

Experience  teaches  that  by  the  use  of  the  same  electrostatic 
machine  or  the  same  static  induction  apparatus,  which  is  actu- 
ated by  the  same  motor,  we  may  produce  sparks  of  very  differ- 
ent shape. 

In  the  case  of  the  electrostatic  machine  the  shape  and  area 
of  the  surfaces  between  which  the  sparks  strike  are  of  great  im- 
portance in  this  respect. 

When  the  hand  is  brought  near  a  pole  of  the  electro- 
static machine  a  series  of  branched  sparks  are  produced, 
which  become  ordinary  sparks  as  the  hand  is  approached 
still  nearer.  The  ramifications  in  the  first  instance  are 
to  be  explained  by  the  atmospheric  resistance;  the  dis- 
charge ahvays  follows  the  line  of  least  resistance  through 
the  air,  and  these  lines  are  determined  by  the  presence 
of  aqueous  vapour  and  particles  of  dust,  which  increase 
the  atmospheric  conducting  power.  When  the  appa- 
ratus is  worked  very  vigorously  these  ramified  sparks  are 
changed  more  and  more  into  a  so-called  "aigrette";  the 
latter  can  only  be  seen  in  the  dark,  but  still  consists  of  a 
series  of  finely-ramified  sparks.  The  electric  discharges 
become  more  uniform  when  the  machine  is  acting  vig- 
orously or  when  the  terminal  knob  is  small;  the  thinner 
the  end  of  the  conductor,  the  more  continuous  becomes 
the  discharge,  c.  g^.,  the  less  can  one  observe  single  rami- 
fications from  the  aigrette;  the  latter  becomes  smaller 
and  smaller,  devolving  finally  Into  a  small  point  of  light. 


';  Ann,  d'C'lcctrol.ioIngic,  Vol.  Ill,  p.  334. 


ii6  RADIO-THERAPY 

Faraday  described  four  kinds  of  electrostatic  dis- 
charge : 

1.  The  spark  proper, 

2.  The  brush. 

3.  The  aureola. 

4.  The  invisible  discharge. 

I.  Tlie  Spark.  When  an  earthed  conductor  is  brought 
near  another  conductor  charged  with  electricity,  a 
shaft  of  light  is  seen  between  the  two,  indicating  the  in- 
termittent discharge  between  them.  When  the  distance 
~  between  the  conductors  is  small,  the  path  of  the  spark  is 
marked  by  a  straight  luminous  beam  of  equal  thickness 
throughout;  the  thickness  and  brightness  of  the  spark  de- 
pends solely  upon  the  quantity  of  electricity;  when  the 
spark-gap  is  made  longer  the  spark  maintains  its  bril- 
liancy and  thickness  at  both  ends,  but  becomes  thinner  in 
the  middle.  When  the  distance  exceeds  a  certain  limit 
and  the  discharged  electrical  quantity  increases,  the  spark 
takes  the  form  of  a  series  of  zig-zag  lines  having  purple- 
coloured  ends;  when  the  sparking  distance  is  still  more 
increased,  ramifications  make  their  appearance  and 
streaks  of  light  are  seen  flowing  off  from  the  corners  of 
the  zig-zag.  B.  Walter  ^)  found  that  the  electric  spark 
is  preceded  by  the  appearance  of  several  intermittent  and 
successively  longer  brush  discharges;  each  of  the  latter 
follows  the  path  of  its  predecessor,  extending  it  a  little 
on  each  occasion.  Thus  we  finally  obtain  either  a  series 
of  ramification  discharges  into  the  air,  or,  with  a  more 
powerful  current,  a  spark  traverses  the  spark-gap. 

2.  The  Brush.  When  a  static  apparatus  is  put  Into 
action  in  the  dark  a  series  of  shining  rays  or  brushes  are 
seen  flowing  off  from  all  prominent  parts  of  the  con- 
ductor with  a  noise  resembling  that  of  a  steam-jet.  As 
a  rule,  these  brushes  consist  of  a  straight  and  brilliant 
stem  ramifying  into  branches  which  again  ramify  in  their 
turn.   These  phenomena  are  better  seen  when  the  second 


')    Wiedemann's  Ann.,   Bd.  LXVI,  p.  636. 


HIGH-FREQUENCY   CURRENTS  117 

(earthed)  conductor  has  a  considerable  surface,  as,  c.  g., 
that  of  a  sphere  or  a  large  disc.  The  electric  brush  is 
only  produced  on  the  positi\c  points  of  the  static  ma- 
chine; it  varies  in  appearance  in  these  places  according 
to  the  shape,  distance  and  arrangement  of  the  conduc- 
tors inducing  the  discharge.  The  negative  points  are 
only  discernible  as  shining  dots  like  stars.  Both  the 
brush  and  the  spark  itself  are  intermittentdischarges;  this 
can  be  proved  by  means  of  rotary  mirrors.  The  brush 
is  formed  by  the  rapid  succession  of  weak  discharges, 
which  only  represent  a  fraction  of  the  total  electricity 
collected  on  the  conductor;  the  spark  proper, on  the  other 
hand,  discharges  the  conductor  completely.  Both  kinds 
of  discharge,  however,  according  to  Faraday  and  Gau- 
gain,  are  seen  where  the  same  potential-difference  ob- 
tains; other  conditions  may,  therefore,  transform  a 
brush  into  a  spark  or  vice  versa.  For  instance,  sparks 
were  produced  by  an  influence  apparatus  working  with 
a  definite  sparking  distance,  which  only  gave  brushes 
when  the  rotation  of  the  apparatus  was  accelerated,  the 
capacity  of  the  conductor  increased,  a  condenser  con- 
nected, or  an  auxiliary  spark  employed. 

When  a  thin  metal  wire  is  suspended  from  a  conduc- 
tor which  Is  drawing  sparks  from  a  powerful  electric  ma- 
chine the  wire  becomes  luminous  in  the  dark,  short  rays 
being  seen  to  dart  from  it  in  all  directions.  1  he  same 
phenomenon  is  observed  in  the  wires  connecting  the  sec- 
ondary poles  of  a  powerful  Riilimkorff's  coil  with  a 
conductor  oftering  considerable  resistance,  such  as  a  very 
hard  Roentgen  tube.  High-frequency  currents,  too,  pro- 
duce brush  discharges  on  conducting  wires  through  which 
they  pass. 

3.  The  Shimmcring-liglil  (aureola)  and  Invisible 
Discharge.  When  the  terminals  of  the  condenser  of  a 
static  apparatus  end  in  very  small  metallic  spheres,  often 
a  light  of  varying  brilliance  and  size  Is  to  be  observed 
playing  about  the  spheres. 

According  to  Faraday,  in  order  to  convert  the  brush 


ii8  RADIO-THERAPY 

into  an  aureola  the  dimensions  of  the  conductor  must  be 
diminished,  the  output  of  electricity  from  the  machine 
must  be  increased,  and  the  conductor  must  be  strictly 
isolated.  In  the  air  the  negative  aureola  is  much  less 
than  the  positive.  This  peculiarity  is  particularly  well 
shown  when  the  discharge  takes  place  in  rarefied  gases. 
Examined  spectroscopically,  the  auroelia  shows  appear- 
ances which  depend  upon  the  nature  of  the  conductor, 
upon  the  character  of  the  gaseous  medium,  and  upon  the 
pressure  of  the  latter,  the  strength  of  the  discharge,  etc. 
Lines  are  found  in  the  spectrum  of  the  sparks  which  are 
characteristic  of  the  metal  of  which  the  electrode  is  com- 
posed. The  spectrum  of  the  brush-discharge  shows  the 
same  qualities  as  the  aureola  and  the  spark  proper. 

Gail  gain  (quoted  by  Mascart)  showed  that  by  using 
equal-sized  spheres  as  conductors  the  sparking  distance 
and  the  tension  are  almost  proportional;  according  to 
Riess,  however,  this  only  holds  good  for  small  distances 
up  to  4  or  5  mm.  Discharge  occurs  most  readily  be- 
tween a  small  positive  and  a  large  negative  sphere. 

According  to  Harris,  the  quantity  of  electricity  nec- 
essary to  produce  a  spark  is  directly  proportional  to  the 
atmospheric  pressure  in  the  spark-gap. 

Dobereiner  and  Cailletet  observed  that  the  length  of 
the  spark  decreases  when  the  pressure  is  raised  beyond 
one  atmosphere. 

Numerous  investigations  have  proved  that  a  spark 
passes  through  the  air  much  more  freely  when  the  press- 
ure decreases;  under  these  conditions  the  spark  is  also 
"fatter."  This,  however,  only  holds  good  up  to  cer- 
tain limits;  beyond  these  the  resistance  of  the  gaseous 
medium  becomes  progressively  more  effective;  when,  in- 
deed, the  vacuum  is  absolute  the  resistance  becomes  in- 
vincible. 

According  to  Harris,  the  sparking  distance  between 
two  spheres  in  connection  with  both  terminals  of  the  con- 
denser is  proportional  to  their  electric  charge.  Thom- 
son found  that  the  potential  difference  required  to  pro- 


HIGH-FREQUENCY  CURRENTS  119 

duce  a  spark  In  the  air  between  two  parallel  plates  does 
not  increase  in  the  same  proportion  as  the  sparking  dis- 
tance when  the  plates  are  further  removed  from  each 
other.  The  relation  between  these  two  quantities  (po- 
tential difference  and  sparking  distance)  is  only  constant 
at  distances  of  more  than  i  mm. 

Jt^iedemanns  and  Riihlmann' s  experiments  showed 
that  the  potential  difference  necessary  for  the  discharge 
increases  more  slowdy  at  low  atmospheric  pressures  as  the 
sparking  distance  is  increased.  This  applies  to  sparking 
distances  between  2  and  30  mm.  Gaugciin  assumes  that 
the  resistance  of  the  medium  is  overcome  by  electrical 
pressure ;  he  thinks  it  of  greater  importance  to  know  the 
electrical  density  at  which  spark  discharges  occur  than 
to  define  potential  difference.  He  showed  by  means  of 
two  charged  cylinders  placed  one  within  the  other  that 
the  production  of  sparks  depends  upon  the  size  of  the 
surface  of  the  inner  cylinder,  /.  e.,  to  the  density  of  the 
electricity  accumulated  on  its  surface. 

Riess  found  that  the  heat  developed  by  an  electrical 
discharge  depends  upon  the  same  law  that  Joule  enun- 
ciated in  the  case  of  electric  currents — the  caloric  quan- 
tity produced  in  a  conductor  which  is  traversed  by  an 
electric  discharge  increases  in  duplicate  proportion  with 
the  intensity  of  the  current,  and  in  direct  proportion  with 
the  resistance  in   the  conductor. 

Franklin,  Arago  and  Ridolfj  demonstrated  the  mag- 
netising effect  of  static  discharges.     Masson  proved  also 
that  induction  phenomena  followed  the  static  discharge. 
The  character  of  the  sparks  produced  by  a  static  conductor 
depends  mainly  upon  the  intensity  of  the  currents,  the  rate  of 
interruption,  the  sparking  distance  and  the  quality  of  the  con- 
ductor  surfaces.      The    action    of   positive    and    negative    dis- 
charges will  be  discussed  later.      With  a  comparatixcly  slow 
rate  of  interruption  (e.  (/.,  by  Neef's  hammer)  the  spark  makes 
Its  appearance  as  a  simple  Hash  of  light;  with  a  quicker  inter- 
ruption rate    {e.  ^.,  by  a  turbine  interrupter),  as  a  sheaf  of 
sparks;  with  an  extremely  rapid  interruption  rate   (such  as  is 


I20  RADIO-THERAPY 

produced  by  an  electrolytic  interrupter),  as  a  thick  stream  of 
light  showing  sometimes  dark  spaces  (the  "caterpillar"  dis- 
charge) ;  with  a  very  quick  rate  of  interruption,  noiseless  dis- 
charges, aigrettes,  and  bundles  of  sparks  may  be  produced,  re- 
sembling very  closely  the  spindle-shaped  bundle  of  violet 
sparks  evolved  from  a  Uiinsliiirst  apparatus. 

The  spark  from  an  apparatus  worked  with  a  fVehnelt's  in- 
terrupter strikes  horizontally  between  two  points  which  are 
placed  opposite  each  other.  When  the  terminals  are  placed 
vertically  and  parallel  to  each  other  the  discharge  takes  the 
shape  of  a  Gothic  arch.  E.  Lecher  experimentally  demon- 
strated the  mobility  of  JJ^ehnelt's  sparks  in  a  magnetic  field  ^). 

F.  Himstedt ")  fixed  a  fine-pointed  terminal  on  one  pole  of 
a  Tesla  transformer.  At  some  distance  (so  great  that  no  spark 
could  traverse  it)  an  insulated  disc  was  placed.  He  found  that 
the  disc  became  always  positively  charged  in  the  atmosphere 
or  in  oxygen,  but  always  negatively  charged  in  any  other  gas- 
eous medium.  This  occurred  quite  irrespective  of  the  direc- 
tion in  which  the  primary  current  was  sent  through  the  ap- 
paratus, or  whichever  pole  of  Tesla's  coil  was  used.  As  the 
disc  is  removed  further  from  the  point  the  positive  charges 
become  weaker  and  weaker,  disappearing  finally  to  be  replaced 
by  negative  ones.  From  this  we  may  infer  that  more  positive 
electricity  than  negative  is  radiated  from  the  point  into  the 
air,  but  that  negative  electricity,  nevertheless,  is  more  capable 
of  being  transmitted  far  into  space  than  is  the  case  with  positive 
electricity. 

In  working  out  his  experiments  the  author  thought  it  ad- 
visable to  investigate,  firstly,  whether  direct  sparks  discharged 
on  the  living  skin  bring  about  changes  which  correspond  to 
those  caused  by  Roentgen  rays;  secondly,  the  histological 
changes  in  a  skin  subjected  to  the  sparking  process;  and, 
thirdly,  the  effect  of  direct  sparks  on  micro-organisms. 

The  following  apparatus  was  used  to  produce  the  spark- 
discharges  : 


')   Sitzungsbericht  d.  Kais.  Akad.  d.  Wiss.  Part  Ua,  Vol.  CVIII.  June  8. 
1899. 

")    Wiedemann's  Ann.,  Vol.  LXVIII,    1899,  p.  294. 


HIGH-FREQUENCY  CURRENTS  121 

1.  A  Roentgen  outfit,  consisting  of  a  40  cm.  coil,  manu- 
factured by  M.  Kohl,  Chemnitz.  On  the  primary  coil  are 
220  windings  of  3  mm.  thick  copper  wire;  the  secondary  coil, 
however,  has  58,000  to  60,000  windings  of  .075  mm.  wire, 
with  a  resistance  of  20,000  ohms.  The  primary  current  in  one 
series  of  experiments  was  provided  by  a  battery  of  accumulators 
(12  volts)  ;  in  another  scries  by  direct  current  from  the  main 
(no  volts).  The  primary  current  was  interrupted  by  a  mer- 
cury-break. The  rate  of  interruption  varied  between  5,  8  and 
16  per  second,  according  as  larger  or  smaller  resistances  were 
inserted  into  the  motor  circuit. 

2.  A  Roentgen  apparatus  manufactured  by  Siemens  ^ 
Halske,  consisting  of  a  30  cm.  coil  and  with  windings  as  fol- 
lows : 

Primary       coil,    408.       windings,        0.25      ohm,     2.         mm.  thickness. 
Secondary     "        68.200         "  52.000      "  o.io 

This  apparatus  was  ahvays  worked  from  the  main.  A 
mercury  turbine  break  was  used  in  conjunction  with  it,  giving 
a  constant  rate  of  interruption  of  100  per  second. 

3.  A  d'Arsomal  apparatus  manufactured  by  Gaiffe,  of 
Paris. 

Each  experiment  was  repeated  two  or  three  times,  and  was 
only  regarded  as  conclusive  when  the  results  were  in  agreement 
on  each  occasion. 

(a)      Investigations  on  the  /Id ion  of  the  Spark-Discharge  on 
the  Body  Surface. 

Exp.  I.  February  23rd,  1900.  A  healthy  guinea- 
pig  was  placed  in  a  suitable  wooden  case  having  a  2  cm. 
square  aperture  cut  away  corresponding  to  the  right 
flank  of  the  animal.  The  end  of  a  wire  coming  from  one 
pole  of  the  coil  /  was  fixed  opposite  this  aperture  at  a 
distance  of  3  cm.  from  the  animal's  skin.  The  aper- 
ture in  the  case  was  closed  by  a  thin  cardboard  covered 
with  aluminium  foil;  the  foil  was  connected  by  a  wire 
with  the  floor,  the  lower  end  of  the  wire  being  inserted 


122  RADIO-rHERAPY 

in  a  crevice  between  the  wall  and  the  floor.  The  pri- 
mary coil  was  connected  with  the  main ;  the  voltmeter 
constantly  indicated  iio  volts,  while  the  hand  of  the 
amperemeter  indicated  4  or  5  amperes  during 
the  experiment.  There  were  16  interruptions  to  the  sec- 
ond; time  of  exposure,  45  minutes.  When  the  sparks 
were  first  applied  the  animal  squeaked  a  little,  after- 
wards it  became  quiet  and  showed  only  a  quicker  rate 
of  respiration.  During  the  whole  experiment  sparks 
were  incessantly  striking  from  the  end  of  the  conducting 
wire  into  the  floor. 

The  same  procedure  was  adopted  on  February  24th 
and  25th.  On  the  26th  the  hair  of  the  treated  skin 
yielded  to  slight  traction;  by  the  28th  there  was  a  bald 
spot  the  size  of  a  finger  nail.  The  animal  remained 
for  a  time  quite  lively  and  well  and  took  nourishment 
properly,  but  on  the  night  of  March  ist  it  died.  Prof. 
JVeichselbatim  made  a  post-mortem  examination  and 
found  but  slight  hyperemia  on  the  lungs,  the  liver  and 
the  kidneys.  There  was  no  ecchymosis  on  the  surface 
of  the  heart  nor  on  the  endocardium.  It  is  an  open 
question  whether  the  animal  died  from  the  effects  of  elec- 
tricity or  from  exposure  to  cold,  since  on  the  night  it 
expired  the  weather  was  very  chilly  and  the  animal  had 
been  kept  in  a  room  without  fire.  Small  apertures  were 
visible  both  in  the  aluminium  foil  and  in  the  cardboard, 
showing  that  thin  sheets  of  this  kind  afford  no  protec- 
tion against  spark-discharge. 

The  result  of  the  experiment  seemed  to  indicate  a 
depilatory  effect  on  the  direct  spark-discharges. 

Exp.  2.  March  7th,  1900.  A  robust  hare,  which 
had  recently  changed  its  fur  so  that  its  present  hair-coat- 
ing was  firmly  fixed,  was  placed  in  a  case  constructed 
similarly  to  that  in  Exp.  i.  The  aperture,  however, 
was  a  little  farger;  the  bare  end  of  the  conducting  wire 
was  not  arranged  as  before,  but  at  a  distance  of  i  cm. ;  a 
contrivance  was  placed  of  the   following  description : 

A  wooden  frame  was  used  as  the  electrode,  covered 


HIGH-FREQUENCY   CURRENTS  123 

by  metal  points  piercing  a  tin-foil  covering  to  the  wood. 
The  metallic  points  were  arranged  in  the  figure  of  a 
cross,  and  were  in  circuit  with  the  secondary  current. 
The  objectwas  to  produce  a  cross-shaped  polar  discharge 
of  sparks,  and  thus,  if  possible,  a  cross-shaped  patch  of 
baldness  on  the  hare's  skin.  At  the  same  time  it  was 
hoped  that  the  larger  quantity  of  electricity  would  be 
collected  on  the  electrode  by  giving  the  latter  a  larger 
surface,  and  that  thereby  the  physiological  effects  would 
be  promoted.  This  expectation,  however,  was  not  real- 
ised, for  the  discharges  did  not  take  place  simultaneously 
from  all  points,  but  generally  from  one  point  only  to  a 
portion  of  the  skin  which  probably  offered  the  least  re- 
sistance. This  single  spark  was  sometimes  seen  wander- 
ing along  the  arms  of  the  cross,  though  it  always 
returned  to  its  starting  point.  The  distance  of  the  elec- 
trode from  the  skin  was  i  cm. ;  the  primary  current  was 
of  2  to  3  amperes,  12  volts,  and  16  interruptions  per 
second;  the  time  of  exposure  was  30  minutes.  The  ani- 
mal, though  at  first  evidently  disturbed,  behaved  quite 
quietly  on  the  whole.  The  same  procedure  was  repeated 
on  March  8th  and  9th. 
On  March  loth  numerous  hairs  fell  off  from  the  parts 
treated,  the  remaining  hairs  being  very  much  loosened.  The 
wool  among  the  hairs  was  still  adherent  and  had  become  singu- 
larly clogged  and  twisted.  On  the  rest  of  the  body  the  hair 
was  not  affected. 

F^xp.  J.  Hitherto  only  one  pole  of  a  spark-coil  had 
been  employed  in  connection  with  the  electrode;  now 
the  second  pole  was  earthed;  the  discharges  then  from 
the  electrode  to  the  skin  appeared  much  more  vigorous 
and  traversed  a  greater  sparking  distance  than  in  Exp.  2. 
Exp.  ^.  The  case  with  the  animal  in  it  was  con- 
nected with  the  floor  in  the  following  way:  The  recep- 
tacle was  placed  on  a  metallic  sheet  which  earthed  by  a 
wire.  By  these  means  we  obtained  the  same  result  as 
in  Exp.  3  ;  the  sparks  were  more  vigorous  and  traversed 
a  greater  distance. 


124 


RADIO-THERAPY 


Clearly  the  resistance  offered  to  the  passage  of  electricity 
from  one  pole  to  the  other  was  lessened  by  the  above  contriv- 
ances. The  entire  resistance  offered  in  the  passage  of  the  dis- 
charge from  one  pole  to  the  wire,  the  electrode,  the  air,  the  ani- 
mal, the  earthing  wire,  and  the  floor  back  to  the  second  pole 
was  apparently  less  than  the  resistance  offered  by  the  air  be- 
tween the  two  secondary  poles  themselves.     (See  diagram  45.) 

The  animal  was  treated  daily  in  this  manner  until  March 
1 8th.  On  this  day  several  bald  spots  were  visible  on  the  right 
flank  within  the  zone  of  the  radiation.  Everywhere  else  the 
hair  was  quite  firm,  except  at  the  root  of  the  left  ear  and  on 


Y.>.-9//A'.'7;'/>;>'^////M////yi/j///r'.v>///////^/^^/^//////^.'^//^^777r\ 


WA>w;>;'r 


Fig.  45. 


the  outer  side  of  the  left  fore-paw;  here  also  there  were  bald 
places.  It  was  found  that  the  latter  places  had  been  in  contact 
with  the  metallic  fastening  of  the  case  during  the  experiment, 
for  from  time  to  time  sparks  had  been  observed  striking  be- 
tween these  parts  of  the  body  and  the  metal. 

On  March  19th  a  completely  bald  white  patch  3-4  mm. 
in  width  was  observed  on  the  skin  corresponding  to  the  hori- 
zontal arm  of  the  cross  of  metal  points.  There  were,  more- 
over, three  bald  spots  the  size  of  a  lentil,  arranged  In  a  straight 
line  and  corresponding  to  the  vertical  arm  of  the  cross.      Be- 


HIGH-FREQUENCY   CURRENTS  125 

sides  these  spots  the  rest  of  the  skin  coinciding  with  the  aper- 
ture appeared  but  sparsely  covered,  and  there  were  numerous 
places  the  size  of  a  kroner  which  were  quite  destitute  of  hair. 
The  skin  itself  appeared  quite  normal,  with  the  exception  of 
some  few  excoriations  the  size  of  a  pinhead;  the  latter  were 
probably  due  to  very  strong  sparks. 

Fresh  hair  began  to  grow  again  in  the  course  of  a  week  on 
all  the  places  except  those  corresponding  to  the  cross;  in  the 
latter  situation  about  four  weeks  elapsed  before  there  was  any 
recovery  of  hair. 

Exp.  5.  March  21st,  1900.  The  animal  was  now 
so  placed  that  its  left  fiank  coincided  with  the  aperture 
in  the  case;  in  front  of  this  case  the  same  electrode  was 
fixed,  at  a  distance  of  1  cm.  The  electrode  was  con- 
nected with  the  coil  terminal  of  an  Oiidins  resonator; 
the  latter  again  was  in  connection  with  a  d' Arsonval's 
condenser  and  the  spark-coil  /.  The  primary  current  of 
the  coil  was  of  1 2  volts  and  2  to  3  amperes,  the  rate  of 
interruption  16  per  second;  time  of  exposure,  10  min- 
utes. By  this  arrangement  much  brighter  sparks  were 
induced  than  in  the  case  of  the  previous  experiment. 

On  the  following  day  a  scab  of  dry  blood  the  size 
of  a  lentil  was  visible  on  the  exposed  area  of  skin ;  the 
operation  was  repeated  under  the  same  conditions  on 
March  22nd  and  23rd. 

On  March  24th  the  animal's  coat  showed  the  same 
changes  as  in  the  case  of  direct  polar  discharges  from  the 
coil,  i.  e.,  loosening  and  falling  of  the  hair  and  clogging 
together  of  the  woolly  undergrowth.  The  experiments 
were  continued  on  March  24th,  25th  and  26th.  By  the 
latter  day  the  area  of  skin  corresponding  to  the  electrode 
appeared  almost  bald;  the  rest  of  the  hair,  moreover, 
coinciding  with  the  aperture  of  the  case  had  become  very 
thin  and  loose.  The  skin  itself  appeared  quite  normal 
during  the  whole  experiment,  except  for  the  above-men- 
tioned excoriation,  which  soon  healed.  In  this  case,  also, 
fresh  hair  did  not  appear  until  the  expiration  of  some 
weeks. 


126  RADIO-THERAPY 

The  above  experiments  ccncliisivcly  proved  that  in  animals 
the  hair  can  be  made  to  fall  by  applying  spark-discharges, 
whether  in  the  form  of  a  direct  polar  discharge  or  as  the  efflu- 
vium from  a  d' Arsonval-Oudin' s  apparatus. 

(b)    Experiments  on  the  Action  of  Spark-Discharges  on 

Bacteria. 

The  organism  chosen  for  these  experiments  was  staphylo- 
coccus pyogenes  aureus,  this  possessing  an  average  capacity 
for  resisting  deleterious  influences. 

Exp.  6.  April  3rd.  A  small  portion  from  a  fresh 
culture  of  staphylococcus  pyogenes  aureus  was  taken 
on  a  strip  of  platinum,  and  with  this  the  nutrient  agar 
of  2  Petri' s  dishes  A  and  B  were  inoculated.  Culture  A 
was  deposited  for  24  hours  in  the  incubator,  and  served 
for  control  purposes;  culture  B  was  uncovered  and  ex- 
posed to  the  electrode  employed  in  Exp.  2  at  a  distance 
of  I  cm.,  the  electrode  being  connected  with  one  pole  of 
the  secondary  coil  of  a  Ruhmkor^'s  apparatus.  The 
primary  current  was  of  2  amperes  and  12  volts;  there 
were  16  interruptions  per  second.  The  culture  was 
treated  to  the  sparks  for  15  minutes,  a  metal  dish  being 
afterwards  placed  beneath  it  and  earthed  by  means  of 
a  wire;  the  culture  was  then  exposed  to  the  discharge  for 
15  minutes  more,  and  after  that  placed  in  the  incubator 
for  18  hours. 

April     4th.      Culture     A     shows     a     well-developed 
growth;  culture  B  shows  very  slight  signs  of  growth.     In 
the   middle  of   it,    indeed,    there   Is   an   absolutely   sterile 
patch  the  size  of  a  kreutzer.     This  area  corresponds  ex- 
actly with  the  middle  portion  of  the  metallic  electrode, 
from  whence  most  of  the  sparks  had  been  seen  to  strike. 
The  experiment  was  repeated  several  times,  and  the  conclu- 
sion appeared  justified  that  the  efect  of  direct  sparking  is  to 
hinder  the  development  of  cultures  of  staphylococcus  pyogenes 
aureus. 

The  object  later  was  to  disperse  the  spark-discharge  over 


HIGH-FREQUENCY   CURRENTS  127 

a  large  surface,  making  it  everywhere  of  equal  intensity.  The 
cross-shaped  electrode  was,  therefore,  dispensed  with,  and  a  me- 
tallic brush  4^  cm.  by  2  cm.,  the  construction  of  which  was  like 
that  of  the  brush  electrodes  used  in  general  faradisation,  was 
employed  (electrode  II)  ;  or  a  faradic  brush  having  a  diam- 
eter of  I  cm.  was  used  (electrode  III), 

Exp.  7.  April  4th.  Three  cultures,  A,  B,  C,  are 
made  on  nutrient  agar  from  plate  J  of  the  last  experi- 
ment, a  streak  2  cm.  in  width  being  inoculated  in  each  in- 
stance. Culture  /^  is  placed  in  the  incubator;  electrode 
II  is  placed  over  the  middle  of  cultures  B  and  C  so  that 
its  longest  diameter  coincides  with  that  of  the  streak  of 
bacteria.  Culture  C  is  electrically  earthed;  distance  of 
the  electrode,  i  cm.;  primary  current,  2  amperes,  12 
volts;  interruptions,  16  per  second;  time  of  exposure,  20 
minutes  each.  Culture  C  is  seen  to  receive  stronger 
sparks;  after  the  experiment  each  culture  is  deposited  in 
the  incubator  for  1 8  hours. 

April  5th.  Culture  J  has  developed  well,  also  cul- 
ture B,  the  latter  showing  a  uniform  growth.  Culture 
C,  on  the  other  hand,  shows  even  to  the  naked  eye  a  bare 
strip  8  mm.  in  length,  corresponding  to  the  middle  of  the 
electrode. 
This  experiment  shows  that  by  earthing  the  current  the  de- 
velopment of  cultures  of  tJiis  organism  is  materially  arrested. 
Exp.  8.  Three  streak-shaped  cultures  of  the  same 
organism  are  made  on  three  agar  plates,  as  in  the  last 
experiment  \A,  B,  C) .  A,  the  control  culture,  is  placed 
in  the  incubator;  a  fourth  culture  D  is  made  in  a  cross- 
shaped  manner.  Culture  B  is  earthed  by  a  wire,  elec- 
trode II  being  placed  opposite  the  middle  of  the  streak  at 
a  distance  of  3  cm.  An  ordinary  brush  electrode  (III) 
is  placed  opposite  the  middle  of  culture  C,  at  a  distance 
of  ;!  cm.,  but  C  is  not  earthed.  /)  Is  arranged  in  such  a 
way  that  the  centre  of  the  cross  is  situated  immediately 
under  electrode  II,  at  a  distance  of  i  cm.  D  is  electri- 
cally earthed. 

B  and  D  are  exposed  for  20  minutes  each;  C  for  30 


128  RADIO-THERAPY 

minutes;  primary  current,  2  amperes,  12  volts;  interrup- 
tions, 16  per  second;  after  the  experiment  all  the  cultures 
are  placed  in  the  incubator  for  18  hours. 
The  object  of  this  experiment  was  to  discover  whether  the 
distance   of   the   electrode    counts    as    a    material    factor,    also 
whether  the  absence  of  proper  electrical  earthing  may  be  com- 
pensated for  by  longer  time  of  exposure  and  shorter  distance 
of  the  electrode,  and,  finally,  whether  the  area  of  the  sterile 
zone  is  proportional  to  that  of  the  active  surface  of  the  elec- 
trode. 

April  6th.     The  result  of  experiment  8  is  as  fol- 
lows:    A  seemed  to  be  well  developed;  in  B  also  no  ar- 
rest of  development  could  be  noticed;  C  shows  a  spot 
of  deficient  development  in  the  centre;  D  an  absolutely 
sterile  spot  the  size  of  a  kreutzer  in  the  centre. 
These  results  clearly  show  that  the  bactericidal  action  of 
spark-discharges  rapidly  decreases  as  the  distance  of  the  elec- 
trode from   the   cultures   increases;  further,    that  absence   of 
proper  electrical  earthing  7?iay  be  to  some  degree  compensated 
for  by  more  prolonged  exposure  and  shorter  distance  from  the 
electrode. 

In  the  case  of  culture  D  the  experiment  shows  that  elec- 
trode II  was  not  adapted  for  equal  dispersion  of  the  spark-dis- 
charge. 

The  next  experiment  was  undertaken  with  the  object  of  find- 
ing whether  stronger  currents  and  longer  exposures  can  com- 
pensate for  greater  distance  between  the  electrode  and  culture.' 
Exp.  g.    April  6th.      In  3  Petri  dishes.  A,  B,  and  C, 
ribbon-shaped  cultures  of  the  same  organism  were  made 
on  agar  as  before;  A,  the  control  culture,  is  placed  in 
the  incubator;  B  is  exposed  to  electrode  II,  at  a  dis- 
tance of  3  cm.,  being  duly  earthed.      Primary  current 
(from  the  main),  4-6  amperes,  1 10  volts;  rate  of  inter- 
ruption, 16  per  second;  time  of  exposure,  20  minutes. 

C  is  also  earthed  and  placed  so  that  the  middle  of 
its  culture  streak  is  at  a  distance  of  3  cm.  from  electrode 
II,  and  exposed  for  45  minutes.  Primary  current,  2 
amperes,  12  volts;  interruptions,  16  per  second.     Each 


HIGH-FREQUENCY   CURRENTS  129 

culture  is  placed  In  the  incubator  for  18  hours  after  the 
experiment. 

April  7th.      ./  is  well-developed;  B  and  C  show  in 

their  centres  a  sterile  patch,  that  of  B  being  the  more 

conspicuous. 

This  experiment  shows  that,  in  spite  of  greater  distance  of 

the  electrode,  the  desired  inhibitory  effect  on  the  organism  can 

still  be  attained  by  prolonging  the  exposure  and  increasing  the 

strength  of  the  primary  current. 

Exp.    10.      In  order  to  investigate  the  manner  in 
which  the  conduction  of  electricity  to  the  floor  takes 
place,  capsule  B  of  the  last  experiment  was  placed,  not 
directly  on  a  metal  plate  as  before,  but  a  sheet  of  black 
paper  w^as  inserteci  betw^een  them.      During  the  experi- 
ment powerful  sparks  could  be  seen   flashing  up   and 
down  along  the  walls  of  the  Petri  dish.      After  the  ex- 
periment the  paper,  when  held  up  to  the  light,  showed  a 
circular  line,  consisting  of  numerous  tiny  holes,  the  ar- 
rangement of  which  exactly  corresponded  with  the  out- 
line of  the  base  of  the  glass  dish.     Thus  the  sparks  had 
evidently  not  struck  through  the  bottom  of  the  dish, 
but  had  taken  their  way  from  the  surface  of  the  agar 
over  the  edge  of  the  dish,  so  transfixing  the  paper. 
1  he  above  experiments  clearlv  prove  that  spark-discharges 
have  the  efi^ect  of  hindering  the  development  of  cultures.      It 
now  remained  to  be  seen  whether  they  were  also  able  to  destroy 
cultures  already  grown. 

Exp.  II.  April  9th.  Two  Petri  dishes,  A  and  B, 
were  each  inoculated  in  a  cross-shaped  manner  with  the 
same  organism  ;  A  serves  for  control  purposes;  B  is  cov- 
ered with  a  sheet  of  paper  and  placed  in  electrical  con- 
tact with  the  floor.  Electrode  II  is  fixed  above  the 
paper  at  a  point  coinciding  with  the  centre  of  the  cross. 
Primary  current,  46  amperes,  iio  volts,  60  interrup- 
tions per  second. 

An  isolated  spot  of  a  well-developed  two-days  old 
culture  (Kxp.  9)  E  is  placed  opposite  the  bare  end  of 
the  wire,  at  a  distance  of  ih  cm.,  and  exposed  for  20 


I30  RADIO-THERAPY 

minutes;  primary  current,  2  amperes,  112  volts;  inter- 
ruptions, 16  per  second.  Afterwards  a  small  part  of 
this  irradiated  portion  is  removed  on  a  strip  of  platinum 
and  an  I-shaped  figure  drawn  with  it  on  a  fresh  nutrient 
agar  E;  from  a  non-exposed  portion  a  I  I-shaped  figure 
is  drawn  on  the  same  agar  E;  all  the  plates  are  then 
placed  in  the  incubator  for  1 8  hours. 

April  10th.     A  is  well  developed;  B  is  also  well  de- 
veloped,  but  shows   in   its  centre   an  absolutely  sterile 
spot  the  size  of  a  pfennig;  the  /  and  the  /  of  capsule  E 
are  also  well  developed;  no  difference  can  be  discerned 
between  these  respective  growths. 
From  the  first  part  of  this  experiment  we  may  conclude 
that  the  discharges  have  a  deleterious  action  on  organisms,  even 
through  a  paper  diaphragm.      The  sheet  of  paper  showed  nu- 
merous punctiform  holes  in  the  centre. 

In  the  second  part  of  the  experiment  any  destruc- 
tive effect  on  grown-up  cultures  had  failed  to  show 
itself. 

Exp.  12.  April  iith.  A  colony  of  a  culture  of 
the  same  organism  two  days  old,  the  size  of  a  pinhead 
a  is  placed  half  a  centimetre  below  electrode  II;  this 
brush  electrode  is  connected  with  apparatus  II;  20  min- 
utes' exposure  is  given.  The  same  is  done  with  a 
second  colony  {b)  for  10  minutes.  Then  "I"  from 
(«),  "11"  from  (/^),  and  "III"  from  a  non-exposed 
portion  of  the  colony  are  grafted  on  fresh  agars,  and 
these  three  plates  (I,  II,  and  III)  are  deposited  in  the 
incubator  for  18  hours. 

During  the  sparking,  which  was  extremely  vivid,  the 
colony  and  its  immediate  surroundings  assumed  a 
bleached  appearance:  this  vanished  after  an  hour  or  so 
and  was  replaced  by  a  brownish  hue;  similar  changes, 
but  less  marked,  were  observable  with  colony  b, 
which  had  not  been  so  long  exposed. 

April  1 2th.  Only  the  last  of  the  plates  which  had 
been  deposited  in  the  incubator  shows  a  III  formed  by 
colonies;  the  others  are  absolutely  sterile,  showing  only 


HIGH-FREQUENCY   CURRENTS  131 

the  furrows  of  the  I  and  II  in  the  agar.  The  spots 
a  and  b  on  the  exposed  plate  appear  more  sterile  than 
their  surroundings. 

Exp.  /J.  April  1 2th.  Exp.  12  is  repeated,  but  at 
a  distance  of  1}  cm.  from  the  electrode. 

April  13th.  The  marks  I,  II  and  III  on  the  three 
plates  show  a  uniform  dev^elopment  of  bacteria ;  thus 
the  greater  distance  of  the  electrode  had  counteracted 
the  effect  of  the  discharge. 

Exp.  i^.  April  13th.  Ihe  general  arrangement 
of  Exp.  1 2  is  adopted,  but  a  larger  colony  of  culture  A, 
in  the  shape  of  a  streak  i  cm.  in  length  and  2mm.  in 
breadth,  is  exposed  for  20  minutes.  From  this  an 
I-shaped  inoculation  is  made  on  plate  B;  also  a  II- 
shaped  inoculation  from  a  non-exposed  portion  is  made 
on  the  same  plate. 

April  14th.  I  and  II  on  plate  B  are  uniformly  and 
thickly  covered  with  bacteria. 
Frequent  and  careful  repetitions  of  Exp.  12  showed,  how- 
ever, that  small  colonies  the  size  of  a  pinhead  may  be  destroyed 
by  a  lo-minutes'  exposure  under  the  above-described  conditions. 
The  failure  of  Exp.  14  may,  therefore,  be  ascribed  to  a  too 
short  exposure  of  so  extensive  a  colony.  It  follows  from  this 
that  by  employing  sufficiently  strong  high-tension  primary  cur- 
rents and  a  sufficiently  quick  rate  of  interruption,  spark-dis- 
charges can  be  produced  which,  ivith  the  electrode  at  a  moderate 
distance  and  a  comparatively  long  exposure,  can  destroy  bac- 
terial cultures  which  are  several  days  old  and  fully  developed. 

In  the  later  experiments  the  current  in  the  primary  coil  was 
so  directed  that  the  disc  of  the  spark-gap  was  always  cathode 
( — )  and  the  point  anode  (  +  ).  (Sec  p.  64.)  The  object 
of  enquiry  now  was  to  discover  whether  positive  and  negative 
discharges  have  the  same  physiological  effects. 

Exp.  75.  April  13th.  On  a  plate  of  agar  {A)  two 
colonies  of  the  organism  are  deposited  in  the  shape  of 
two  parallel  streaks,  each  about  i  cm.  wide  (  i,  2).  The 
plate  is  earthed  and  the  middle  of  each  streak  exposed 
to  the  brush  clcctrotle  for  i  5  minutes,  at  a  distance  of 


132  RADIO-THERAPY 

I  cm. ;  the  electrode  Is  In  connection  with  the  anode 
(point)  In  the  case  of  streak  i,  with  the  cathode  (disc) 
with  streak  2;  primary  current,  2  amperes,  12  volts,  16 
Interruptions  per  second. 

During  the  experiment  a  marked  difference  can  be 
discerned  In  the  character  of  the  two  discharges.  The 
sparks  from  the  negative  pole  are  thrown  In  a  shaft 
directly  and  vertically  on  the  portion  of  the  agar  near- 
est to  the  electrode.  They  always  occupy  the  same 
site;  the  discharges  from  the  positive  pole,  however,  are 
seen  jumping  from  one  metal  point  of  the  electrode  to 
the  other,  and  show  a  tendency  to  reach  the  circumfer- 
ence of  the  electrode. 

The  same  procedure  Is  repeated  with  a  second  plate 
B,  which  Is  exposed  tor  only  8  minutes.  After  both 
experiments  both  plates  are  deposited  In  the  Incubator 
for  18  hours. 

April  14th.  Both  streaks  on  plate  A  are  well  de- 
veloped, but  show  a  sterile  region  In  their  centre.  This 
In  the  case  of  streak  i  Is  seen  In  the  shape  of  a  clear 
circular  spot  the  size  of  a  lentil;  streak  2  shows  In  Its 
centre  more  Irregular  sterile  streaks  and  foci. 

On  plate  B  only  streak  i  shows  a  small  circular  ster- 
ile patch;  streak  2  Is  nowhere  Interrupted,  but  uniformly 
covered  with  the  growth. 
This  experiment  shows  that  the  bactericidal  effect  of  posi- 
tive spark-discharges  is  not  so  powerful  as  that  of  negative;  also 
that  tJie  action  of  the  latter  is  limited  to  a  smaller  area. 

Further  repetitions  and  control  experiments  confirmed  these 
conclusions. 

Exp.  16.  April  25th,  1900.  A  streak  inoculation 
is  made  on  two  agar  plates  {A  and  B) .  A  brush  elec- 
trode In  connection  with  d' Arsonval-Oiidin's  apparatus 
is  fixed  opposite  the  middle  of  streak  A  at  a  distance  of 
I  cm.  Primary  coil  current,  2  amperes,  12  volts;  inter- 
ruptions,  16  per  second. 

The  brush  electrode  is  also  fixed  at  the  same  dis- 
tance opposite  the  middle  of  streak  B,  but  connected  with 


HIGH-FREOUEXCY   CURRENTS  133 

the  cathode  of  the  coil;  both  plates  are  earthed,  and 
exposed  for  5  minutes  each. 

April  26th,  The  growth  on  B  is  well  developed, 
but  shows  a  sterile  spot  in  its  centre;  streak  J  is  uni- 
formly developed. 

Exp.  ly.  April  26th.  A  streak-shaped  colony  of 
the  organism  in  a  Petri's  dish  is  treated  in  the  middle 
with  discharges  from  a  d' Arsonval-Oudin' s  apparatus 
for  25  minutes. 

April  27th.    The  streak  shows  a  sterile  patch  in  the 

middle. 

These   last  experiments   show   tJiat  spark-discharges  from 

d' Arsonval-Oudin' s  apparatus  act  in  the  same  way  on  bacteria 

as  direct  polar  discharges  from  the  coil,  but  that  the  intensity 

of  action  of  the  latter  is  greater. 

Exp.  18.  April  27th.  Two  streak-shaped  cultures 
of  the  organism  are  made  on  agar;  the  middle  one, 
plate  A,  is  exposed  at  the  distance  of  i  cm.  to  a  brush 
electrode  conveying  the  discharges  of  a  secondary  cur- 
rent, which  is  induced  by  a  primary  current  of  3  to  4 
amperes,  12  volts,  and  16  interruptions  per  second. 
The  middle  of  the  second  streak  B  is  exposed  to  the 
sparks  from  a  primary  current  of  3  to  4  amperes,  iio 
volts,  and  16  interruptions  per  second.  Time  of  ex- 
posure in  each  case  3  minutes,  followed  by  incubation 
for  18  hours. 

April  28th.  Both  cultures  show  uniformly  well- 
developed  uninterrupted  streaks  of  organisms. 

Exp.   ig.     The  last  experiment  was  repeated,  this 

time  with   a   longer  exposure,   viz.,    10  minutes;   both 

streaks  now  show  equal-sized  sterile  patches. 

When  the  time  of  exposure  was  varied  in  still  other  ways 

no  difference  ivas  found  in  the  action  of  primary  currents  of 

varying  tension,  but  of  equal  intensity  and  rate  of  interruption. 

These  findings  are  quite  analogous  to  the  results  of  a  series 

of  experiments  made  by  B.  Jf alter. ^)       'J'he  latter  found  that 


')   Forts.chr.  auf  dcm  Gcbictc  dcr  Rontgcnstrahlcn.  Vol.   II,  p.  31. 


134  RADIO-THERAPY 

the  amount  of  tension  obtaining  in  the  circuit  of  a  primary  cur- 
rent has  no  direct  effect  on  the  length  of  spark  evolved/) 

Exp.  20.  April  27th.  Two  streak  cultivations  of 
the  organism  are  made  on  agar  plates;  the  middle  part 
of  one  (plate  A)  \s  exposed  to  the  spark-discharge  from 
a  brush  electrode  at  a  distance  of  i  cm.  The  electrode 
is  in  connection  with  a  secondary  circuit  induced  by  pri- 
mary currents  of  2  amperes,  12  volts,  and  16  interrup- 
tions per  second.  Plate  B  is  subjected  to  the  same  treat- 
ment, with  the  exception  that  in  this  case  the 
primary  current  is  only  interrupted  8  times  per  sec- 
ond. The  plates  are  earthed  in  both  instances.  Time 
of  exposure  4  minutes,  followed  by  incubation  as  be- 
fore. 

April  28th.      Plate  A  shows  a  well-developed  col- 
ony, with  a  sterile  patch  in  the  centre;  the  growth  in  the 
case  of  plate  B  is  absolutely  uniform. 
We  may  conclude  that  the  rate  of  interruption  of  the  pri- 
mary current  is  an  important  factor  concerning  the  efect  of  the 
spark-discharge. 

Exp.  21.     This  is  a  modification  of  the  last  experi- 
ment.     The  rate  of  interruption  is  again  16  per  second, 
but  the  intensity  of  the  primary  current  is  altered  from 
I  to  4  amperes  by  varying  the  resistances  and  raising  the 
mercury  vessel  of  the  interrupter. 
The  result  showed  that  a  colony  of  bacteria  exposed  to  the 
discharges  from  a  current  of  i  ampere  for  8  minutes  was  not 
hindered  in  its  development;  whereas,  the  latter  event  occurred 
when  another  colony  was  exposed  to  a  current  of  /j.  amperes  un- 
der precisely  the  same  conditions. 

Exp.  22.  April  30th.  A  square  piece  of  annealed 
copper  sheeting  i  sq.  cm.  in  size  is  placed  on  the  floor 
of  a  sterile  Petri  dish  (Fig.  46  K)  ;  from  the  edge  of 
this  piece  of  metal  a  copper  wire  B  leads  to  the  side 
of  the  dish,  and  eventually  to  the  floor.  An  ordinary 
nutrient  agar  medium  is  placed  on  the  copper  sheet,  and 


')   Fortschr.  auf  dem  Gebiete  der  Rontgenstrahlen,  Vol.  II,  p.  31. 


HIGH-FREQUENCY   CURRENTS  135 

after  coagulation  is  uniformly  covered  with  a  small 
quantity  of  the  organism.  Over  the  colony  the  follow- 
ing arrangement  is  placed :  A  disc  of  glass  6  cm.  in  di- 
ameter and  2^  cm.  thick,  with  a  central  hole  2  cm.  in 
diameter,  is  supported  by  three  glass  pedestals;  on  the 
upper  surface  of  the  disc  a  sheet  of  paper  (P)  is  at- 
tached with  sealing-wax  so  as  to  cover  the  central  hole; 
on  this  paper  a  circular  piece  of  fresh  human  skin  (//) 


Fig.  46. 


is  placed.  7^he  edge  of  the  skin  does  not  extend  quite 
to  that  of  the  glass  disc ;  the  hole  in  the  latter  is  arranged 
just  above  the  copper  sheet.  Above  the  whole 
a  brush  electrode  is  fixed  at  a  distance  of  I  cm.,  and  con- 
nected with  the  negati\'e  pole  of  the  secondary  circuit. 
Primary  current,  4  to  <;  amperes,  i  10  volts;  100  inter- 
ruptions per  second;  time  of  exposure,  20  minutes. 
During  the  whole  experiment  a  copious  discharge  of 
sparks  took  place  between  the  perforation  in  the  glass 
disc  and  the  copper  sheet.  After  the  experiment  the 
surface  of  the  skin  appeared  slightly  singed  within  an 
area  coinciding  with  the  aperture  in  the  glass  disc;  the 
paper  showed  a  multitude  of  small  holes  with  scorchcil 
border.  The  glass  disc  was  then  removed;  the  surface 
of  the  nutrient  agar  showed   no  c\itient  changes;  the 


136 


RADIO-THERAPY 


Petri  dish  was  then  closed  and  placed  in  the  incubator 
for  two  days. 

On  May  2nd  the  culture  presented  the  appearance 

shown  in  the  photograph  (Fig.  47).      The  agar  is  seen 

to   be   completely   sterile   in   the   region    corresponding 

to  the  piece  of  copper  sheeting  and  its  wire;  everywhere 

else  the  nutrient  medium  is  seen  to  be  uniformly  covered 

with  a  well-developed  growth. 

This  experiment  proves  that,  even  by  interposing  a  piece  of 

human  skin,  living  bacteria  can  be  absolutely  prevented  from 

developing  by  treating  them  with  negative  polar  discharges  of 

high-tension  induced  currents. 

The  experiments  hitherto  described  were  intended  to  shed 
light  on  the  particular  circumstances  under  which  the  bacteri- 
cidal effect  of  the  electric  discharge  takes  place. 

We  now  proceeded  to  test  the  action  of  polar  discharges  on 
various  other  kinds  of  bacteria,  dealing  especially  with  those 
micro-organisms  which  bear  a  causal  relationship  to  certain  dis- 
eases of  superficial  parts  of  the  body. 

Exp.  2j.  April  20th.  Two  streak-shaped  colonies 
(a,  b)  of  a  culture  of  typhus  bacillus  are  made  on  nu- 
trient agar  in  a  Petri  dish  A^  the  dish  is  placed  in  the 
incubator  for  ^G  hours.      After  this  time  a  uniformly 


Fig.  47. 


Fig.  48. 


Fig.  49. 


well-developed  growth  is  seen  in  the  sites  of  inocula- 
tion; streak  a  is  now  exposed  in  the  central  part  to  the 
negative  discharges  of  a  secondary  current,  which  latter 
is  induced  by  a  primary  current  of  2  amperes,  1 10  volts, 
and  100  interruptions  per  second.      Discharges  are  pro- 


HIGH-FREOUKXCY   CURREXTS  137 

jected  from  a  brush  electrode  at  a  distance  of  i  cm.  The 
Petri  dish  is  electrically  earthed;  time  of  exposure,  10 
minutes.  After  the  experiment  a  small  quantity  is  taken 
from  the  exposed  portion  (which  ajipears  rather  dry) 
and  an  I-shaped  Hgure  is  inoculated  with  it  on  sterile 
agar  B.  A  portion  is  also  taken  from  the  non-exposed 
streak  h  and  a  Il-shaped  figure  inoculated  on  B;  both 
dishes  are  then  placed  in  the  incubator. 

April  2  I  St.  Streak  a  in  dish  J  shows  a  small  hol- 
lowed spot  in  its  midst;  otherwise  it  is  uniformly  co\'- 
ered  with  growth.  On  the  agar  of  dish  B  the  furrows 
made  by  the  "I"  are  completely  sterile;  on  the  other 
hand,  the  "11"  is  everywhere  covered  with  thickly- 
grown  colonies. 

Exp.  2-f.  April  25th.  The  middle  (i)  of  three 
cultures  of  diphtheria  bacilli  several  days  old  is  exposed 
to  the  negative  discharge  of  a  secondary  current  through 
a  brush  electrode;  primary  current,  2  amperes,  iio 
volts;  100  interruptions  per  second.  The  culture  ves- 
sel is  electricallv  earthed.  From  the  exposed  portion 
"I,"  as  in  experiment  22,  is  drawn  on  a  second  agar  B ; 
also  on  the  same  agar  a  "IT"  is  dra\\n  with  a  non-ex- 
posed portion  of  culture  2.  Both  plates  are  then  placed 
in  the  incubator. 

April  26th.  Streak  i  in  plate  .7  shows  a  slightly 
brownish  colour  in  its  centre;  the  I  in  plate  B  is  com- 
pletely sterile,  the  II  thickly  covered  with  colonies  (Fig. 

49)- 

Exp.  25.     April  2^th.     I^xp.  23  is  repeated  with  the 

same   arrangement,    but   this   time   cultures   of   aphthae 

two  days  old  are  usctl ;  the  results  are  (juite  similar  to 

those  in  the  case  of  the  diphtheria  bacilli. 

Exp.    26.     April    2J;th.       I  he    same    procedure    is 

adopted  with  cultures  of  anthrax  two  days  old,  which  are 

treated  by  direct  negati\-e  polar  discharges  from  a  brush 

electrode.       The  first  experiment  gives  negative  results; 

acting  on    Pi7)l.    irc'iclisflhuuiu' s   achice,    the   colony   is 

moistened  with  sterile  bouillon.       \'i\itl  sparks  ensuctl, 


138  RADIO-THERAPY 

with  the  evolution  of  moist  heat,  in  which  the  organisms 
perished  more  easily.  By  these  means  their  destruction 
is  achieved. 

Exp.zy.  May  1 2th.  A  culture  of  tubercle  bacillus 
four  months  old,  cultivated  on  glycerine  agar  in  a  test 
tube  {A)  and  well  developed,  is  treated  as  follows: 

A  wire  in  connection  with  the  negative  pole  of  a  sec- 
ondary coil  perforates  the  woollen  plug  in  the  test  tube 
so  that  its  end  is  placed  vertically  and  at  a  distance  of 


Fig.  50. 


4  mm.  above  the  culture.  Outside  the  test  tube  and  op- 
posite the  wire  a  small  sheet  of  metal  is  fixed;  a  wire 
connects  the  latter  with  the  floor;  primary  current,  2  am- 
peres, 1 10  volts;  100  interruptions  per  second.  Expos- 
ure is  continued  for  10  minutes,  during  which  time 
sparks  are  seen  freely  striking  through  the  tube  in  the  di- 
rection of  the  metal  strip  outside.  (The  surface  of  the 
nutrient  medium  was  placed  in  a  slanting  direction  with- 
in  the   tube   so    as   to   be   traversed   by   the   sparks    in 


HIGH-FREQUENCY   CURRENTS  139 

their  passage.)  After  the  experiment  the  exposed  por- 
tions of  culture  are  apparent  as  two  dark-brown  spots 
the  size  of  a  lentil.  (Fig.  50.)  FVom  these  spots  a 
small  quantity  is  taken  on  a  platinum  spatula,  mixed 
with  a  few  drops  of  sterile  bouillon,  and  a  sterile  sloping 
surface  of  nutrient  glycerine  agar  in  test  tube  /  inoc- 
ulated with  it;  in  the  same  way  a  portion  of  culture  J 
which  had  not  been  exposed  to  the  discharge  is  inocu- 
lated on  a  third  agar  (test  tube  //).  These  three  test 
tubes  are  then  closed  with  plugs  of  cotton  wool  covered 
with  gutta-percha  tissue  and  placed  in  the  incubator. 

After  three  weeks  (June  2nd)  they  were  inspected. 
Test  tube  J  shows  four  sterile  places  exactly  like  each 
other;  test  tube  /,  on  which  the  irradiated  portion  had 
been  ingrafted,  shows  the  surface  of  the  agar  to  be  com- 
pletely sterile;  test  tube  //,  however,  in  which  non-ex- 
posed portions  had  been  inoculated,  shows  several  well- 
developed  colonies   (see  Fig.  50). 

Exp.  28.  A  culture  of  favus,  in  three  well-devel- 
oped streaks  on  agar  and  a  fortnight  old  {A) .,  is  exposed 
in  the  centre  of  its  middle  streak  to  negative  discharges 
from  the  brush  electrode  at  a  distance  of  I  cm.  for  15 
minutes;  primary  current,  2  amperes,  iio  volts,  100  in- 
terruptions per  second;  earthing  of  the  current.  The 
exposed  portion  is  then  moistened  and  mixed  with  ster- 
ile bouillon  and  'T'  of  this  is  inoculated  on  a  second 
agar  B.  Also  a  "11"  of  one  of  the  other  non-exposed 
streaks  is  inoculated  on  B.  Both  vessels  are  then  closed 
and  placed  in  the  incubator. 

Three  days  later  the  'T'  on  vessel  B  appears  sterile; 
the   "II,"   however,    is   thickly  grown   over  with  colo- 
nies. 
In  addition  to  the  preceding  experiments,  experiments  23 
to  28  show  that  it  is  possible  by  direct  polar  discharges  striking 
from  metal  (end  of  the  conducting  wire,  or  brush  electrodes) 
to  prevent  the  development  of  bacterial  cultures;  also,  under 
suitable   experimental   conditions,    to    absolulcly    destroy    even 
ivell-developed   colonies,    several   days    old,    of   staphylococcus 


I40  RADIO-THERAPY 

pyog.  aiir.,  typhus  hacilliis,  diphtheria  hacillns,  anthrax  bacil- 
lus, aphthw,  tubercle  bacillus,  and  achorion  Schonleinii. 

We  must  not,  of  course,  assume  too  much  from  the  results 
of  the  last  two  experiments,  since  it  is  quite  possible  that  these 
results  were  merely  accidental  in  view  of  the  difficulty  presented 
in  the  cultivation  of  these  kinds  of  bacilli  (tubercle  bacillus, 
achorion  Schonleinii).  The  results  of  the  other  experiments, 
however,  may  fairly  be  regarded  as  conclusive,  since  in  their 
case  no  difficulty  of  this  kind  exists. 

Some  reports  on  the  action  of  electricity  on  bacteria 
already  exist.  Mendelsohn  ^)  had  shown  that  the  gal- 
vanic current  is  capable  of  destroying  micro-organisms. 
Apostoli,^)  Laguerriere,'-)  Prochownik  and  Spdth'^)  as- 
cribed this  effect  to  the  electrolytic  action  of  the  current. 
Some  authors  ascribed  similar  effects  to  the  inducing 
properties  of  electricity;  especially  Spilcker  and  Gott- 
stein*)  Burci  and  FroscaniJ')  The  statements  of 
Spilcker  and  Gotlstein  were  disputed  by  Friedenthal^) 
and  KriigerJ) 

Klemperer,^)  Kriiger^^)  and  Smirnozv '^'-)  made 
anti-toxines  from  bacterial  toxins  by  treatment  with  con- 
stant currents  of  80  to  100  m.  a.;  d'Arsonval  and 
Charrin  ^^)  succeeded  in  converting  the  toxins  of  pyo- 
cyaneus  and  diphtheria  bacilli  by  the  electrolytic  action 
of  high-frequency  currents.  Bonome  and  Fial,^^) 
Meade  Bolton  and  II.  D.  Pease  ^•^)  confirmed  d'Arson- 


')   Colin's   Beitrage   zur    Pfianzenphysiologie,    1879;    quoted   by   Gottstcin 
and  Labarsch-Ostcrtag,  1897,  p.  82. 
Sem.  med.,  1890. 
D.  med.   Wochenschr.,   1S90. 
Cenfralbl.  f.  Bakt.  Vol.  IX. 
Quoted  by  Labarsch-Ostcrtag,    1897. 
Centralbl.  f.  Bakt.,  Vols.  XIX  and  XX. 
Zeitschr.  f.  klin.  Med.,  Vol.  XXII. 
Ibid.  Vol.  XX,  p.  165. 
1.  c. 

D.  Med.  Wocbenschr.,  1894,  No.  30. 
1.  c. 

Centralbl.  f.  Bakt.,  Vol.  XIX,  p.  849. 
Journal  of  Experimental  Medicine,   1896,  Vol.  I,  No.  3. 


HIGH-IREOUENCY   CURRENTS  141 

val  and  Charrin's  experiments  on  the  conversion  of  tox- 
ins into  anti-toxins,  but  stated  that  bacteria  themselves 
were  not  in  the  least  influenced.  Marmier^)  repeated 
the  experiments  and  came  to  quite  other  conclusions. 
He  believed  that  by  the  electrolytic  decomposition  of 
the  sodium  chloride  contained  in  the  culture  fluid  hypo- 
chlorites are  produced  which  destroy  the  toxins.  He 
found  that  by  employing  d'Jrsonvcil  and  Charrin's 
method  the  diphtheria  toxins  were  heated  in  12  min- 
utes to  81°  C. 

Tolomei'-)  enquired  Into  the  effects  of  direct  sparks 
on  acetic  fermentation.      When  sparks  from  a  Riilim- 
korff's  apparatus  strike  the  surface  of  the  fermenting 
liquid,  some  arrest  in  the  development  of  the  organisms 
occurs  in  the  case  of  fairly  strong  discharges;  the  liquid, 
however,   is  not  sterilised,   for  after  stopping  the  dis- 
charge the   fermentation  proceeds  again,   though  to  a 
less  extent.      According  to  the  report  of  Destot's  and 
Diibard's  papers,  read  before  the  Congress  on  Tubercu- 
losis,  Paris,    1898,  bacteria  can  be  destroyed  by  static 
electricity. 
How  are  these  negative  discharges  of  high-tension  induced 
currents,  which  have  proved  to  be  so  efficacious,  to  be  used  in 
practice?      The  use  of  the  apparatus  in  the  manner  described 
for  the  foregoing  experiments  is  obviously  out  of  the  question; 
for  one  thing  the  pain  would  be  considerable,  and  the  surface 
of  the  body,  if  irradiated  in  this  manner,  would  be  almost  cer- 
tainly damaged.      Moreover,  the  discharges  would  be  applied 
over  too  small  an  area. 

Many  experiments  had  been  made  with  the  object  of  dis- 
persing the  spark-discharge  over  a  larger  surface,  with  nega- 
tive results.  In  no  case  could  a  simultaneous  discharge  be  In- 
duced from  all  points  of  the  surface  of  the  electrode.  The  au- 
thor made  a  series  of  photographs  of  discharges  from  the 
electrode  in  the  following  way: 


')  Annales  de  I'institut  Pasteur.  1895.  p.  533:  1896.  p.  468. 

')  L'Orosi,  Vol.  XIII,  p.  401-409.  Ref.  Ccntralbl.  f.  Bakt,  Vol.  IX,  p.  540, 


142  RADIO-THERAPY 

A  bromide  of  silver  collotype  him  was  placed  in  a  dark 
room  on  a  metal  plate,  the  latter  being  earthed.  An  electrode 
was  fixed  at  a  distance  of  i  cm.  above  the  middle  of  the  collo- 
type and  a  current  passed  from  the  coils.  The  time  of  exposure 
amounted  to  only  a  few  seconds;  with  a  longer  exposure  the 
whole  collotype  would  have  been  diliusely  blackened.  In  this 
way  a  graphic  picture  was  obtained  of  the  positive  discharges 
which  were  seen  to  flow  off  in  all  directions  towards  the  metal 
plate  (see  plate,  Fig.  i).  Another  picture  showed  the  more 
constant  course  of  negative  polar  discharges,  which  always  keep 
the  same  situation  and  follow  the  shortest  course  to  the  metal 
plate  (see  plate,  Fig.  2) .  Pictures  of  the  discharges  from  brush 
electrodes  (plate,  Fig.  3) ,  also  those  from  pencil  electrodes  (Fig. 
4) ,  show  very  distinctly  a  series  of  round  spots  where  the  sparks 
successively  struck  the  film.  From  these  photographs,  as  well 
as  from  inspection  of  the  process  of  sparking  itself,  it  be- 
came quite  clear  that  none  of  these  electrodes  would  quite  meet 
the  case.  In  consideration  of  the  fact  that  in  all  these  experi- 
ments good  conductors  had  been  employed,  the  author  now  de- 
termined to  try  bad  conductors. 

Exp.  2g.      A  piece  of  wood  was  placed  within  the 

lumen   of  an   ordinary  wooden  bobbin   and  connected 

with  the  conducting  wire  of  the  negative  pole.     The 

bobbin  was  fixed  above  the  collotype  in  the  same  way 

as  before. 

The  negative,  on  being  developed,  showed  a  bright  circle 

corresponding  to  the  base  of  the  bobbin,   with  a  completely 

blackened  surrounding.      This  blackening  was  evidently  caused 

by  the  quiet    (invisible)    discharges  from  the  bobbin.       This 

experiment  suggested  the  following : 

Exp.  JO.  By  Prof.  Valenta's  advice  the  wooden 
electrode  was  shaped  like  a  cylinder,  the  thickness  of 
a  thumb,  with  its  ends  rounded;  this  was  placed  in  a 
glass  receptacle  which  left  only  that  side  free  which 
faced  the  collotype;  the  conducting  wire  was  conveyed 
through  the  glass  to  the  electrode. 
The  photograph  obtained  by  the  use  of  this  apparatus  ap- 
peared distinctly  more  promising.     In  addition  to  a  number  of 


HIGH-FREQUENCY   CURRENTS  143 

spots  corresponding  to  the  varying  position  of  the  spark-shaft, 
there  was  a  rather  diiiuse  and  more  uniform  action,  as  shown  in 
the  plate  (Fig.  5), 

Instead  of  an  imperfect  conductor,  such  as  wood,  a  thor- 
oughly bad  conductor,  glass,  was  now  chosen.  Experiments 
with  glass  alone  failed.  An  electrode  was  now  contrived  (Exp. 
31)  by  filling  a  test  tube  with  water,  closing  it  with  a  cork,  and 
conveying  the  conducting  wire  through  this  cork  to  the  surface 
of  the  water,  it  was  soon  seen  that  one's  object  had  been 
more  nearly  attained ;  discharges  proceeded  from  the  lower  end 
of  the  test  tube  in  a  regular  and  uniform  manner,  in  the  form  of 
a  number  of  thin  blue  rays  streaming  off  simultaneously.  The 
photograph,  too  (see  plate.  Fig.  6),  gave  satisfactory  results — 
the  discharges  had  produced  a  diffuse  circular  blackening  figure, 
which  showed  only  an  insignificant  bright  spot  in  the  centre. 
(The  plate,  of  course,  shows  the  photographic  process  reversed, 
/.  e.,  the  black  spots  are  white,  and  vice  versa.) 

The  last  defect  was  removed  when,  instead  of  the  test  tube, 
a  small  glass  flask  of  about  8  mm.  in  diameter  was  employed 
(Exp.  32),  and  arranged  as  the  test  tube  had  been.  Dis- 
charges from  this  instrument  gave  a  perfectly  uniform  and 
simultaneous  effect.  Their  photograph  appeared  as  a  circular 
uniformly  blackened  disc  (see  plate,  Fig.  7),  the  diameter  of 
which  amounted  to  about  8  cm.,  that  is,  about  10  times  the  diam- 
eter of  the  electrode. 

These  diffusely  radiating  discharges,  which  cause  but  feeble 
light  effects,  have  been  known  for  a  long  time;  the  peculiar  light 
effects  which  are  seen  in  the  dark  on  mast-tops,  the  ends  of  light- 
ning rods,  tree-tops,  etc.,  which  were  named  after  Castor  and 
Pollux  by  the  ancients,  and  called  St.  Elmo's  fire  in  our  times, 
belong  in  the  same  class  of  phenomena.  Points  which  are  ap- 
proached to  a  conductor  charged  with  electricity  collect  this 
electricity  in  a  high  state  of  tension  and  part  with  it  to  the 
surrounding  air.  l^hc  electricity  thus  imparted  to  the  air  is 
repelled  by  that  of  like  kind  still  remaining  in  the  points,  and 
leads  away  the  electricity  accumulated  on  the  conductor;  thus 
the  result  is  the  same  as  though  the  electricity  streamed  directly 
from  the  points.      When  the  electricity  streaming  oft  points  in 


144 


RADIO-THERAPY 


this  manner  is  conducted  to  the  ground,  the  appearance  of  a 
bluish  vapour  is  produced;  when,  however,  the  space  between 
the  point  and  the  earthing  wire  is  increased,  the  electricity 
streams  away  almost  invisibly:  it  is  now  more  readily  discernible 
by  the  sense  of  touch  than  that  of  sight. 

Exp.  JJ.  An  investigation  now  took  place  of  the 
action  of  negative  polar  discharges  from  the  last-men- 
tioned (flask)  electrode  when  directed  towards  an 
earthed  metal  plate;  also  as  to  their  behaviour  when  a 
glass  plate  is  inserted  between  the  electrode  and  the 
metal  plate.      The  following  table  gives  the  results: 


Flask-Electrode 

Glass-Plate 

Earth-Conduction 


Flask-Electrode 

I 
Earth-Conductor 


1.  Contact  of  the  electrode  with  the 
glass  plate  gives  a  powerful  dif- 
fused blue  light,  from  which  no 
other  visible  rays  stream  off. 

2.  When  the  electrode  is  gradually 
removed  the  light  becomes  con- 
centrated into  numerous  blue  rays, 
with  one  central  brighter  ray. 

3.  With  still  greater  distance  of  the 
electrode,  the  central  ray  becomes 
brighter  and  more  pronounced, 
while  the  other  rays  become  cor- 
respondingly feeble. 

4.  With  still  greater  distance  the 
central  ray  also  disappears  ;  a  dif- 
fused bluish  halo  is  now  seen 
round  the  electrode. 


1.  Contact  9f  the  electrode  with  the 
metal  plate  gives  numerous  but 
weaker  luminous  rays. 

2.  With  the  electrode  a  sliort  dis- 
tance from  the  plate,  one  thick 
luminous  ray  appears. 

3.  With  the  distance  increased 
numerous  weak,  but  still  luminous, 
side-rays  appear  surrounding  the 
central  ray. 

4.  With  the  distance  still  increased, 
the  central  ray  disappears,  and 

5.  The  electrode  appears  surrounded 
by  a  bluish  luminous  halo. 


Exp.  j^.  Similar  phenomena  were  observed  when 
the  electrode  was  only  half  filled  with  water,  in  which 
the  end  of  the  conducting  wire  was  immersed. 

Exp.  55.  The  experiment  was  repeated  with  the 
electrode  empty.  With  the  electrode  in  contact  with 
the  glass  plate  a  feeble  light  was  seen;  this  disappeared 
as  the  electrode  was  removed.  Precisely  the  same  effect 
was  produced  when  the  metal  plate  was  substituted  for 
the  glass  plate. 

Exp.  ^6.  In  order  to  decide  whether  the  size  of  the 
electrode  has  anything  to  do  with  the  quality  of  the  dis- 


HIGH-FREQUENCY  CURRENTS  145 

charge,  a  spherical  electrode  filled  with  water  was  used, 
4  cm.  in  diameter.  With  this  apparatus  no  such  dis- 
persion of  the  discharges  could  be  eiiected  as  with  the 
smaller  electrode.  When  the  electrode  was  placed  i 
cm.  from  the  glass  plate,  about  a  dozen  thick  bluish 
rays  were  seen  striking  from  its  base.  As  the  electrode 
was  approached  still  nearer  to  the  plate  the  rays  became 
thinner  and  gradually  brighter. 

^■^'P-   37-      In   order  to   decide  whether  these   dis- 
charges caused  any  sensation  of  pain  or  touch,  the  back 
of  one's  hand  was  approached  to  the  electrode  in  action 
(electrode  VI).      At  a  considerable  distance  even  the 
hand   had  the  sensation   of  being  breathed  upon;  this 
sensation  increased  as  the  hand  was  brought  still  nearer 
to  the  electrode,  and  at  a  distance  of   i .',  cm.  a  spark 
struck   the  skin.    There  was   absolutely  no   feeling  of 
pain.     Repeating  the  experiment  with  the  larger  water- 
sphere  electrode    (electrode   \'II),   a   faint  sensation  as 
though  the  skin  were  being  stroked  with  hair  was  felt 
even  at  a  distance  of  half  a  meter.      This  phenomenon 
occurred  when   the   hand  was  moved  in   any   direction 
within  this  radius. 
The  effects  of  uni-polar  discharges  of  high-tension  induced 
currents  differ  slightly  from  those  of  high-frequency  currents. 
In  the  form  of  a  simple  spark-discharge  they  produce  a  small 
wheal  on  the  skin,  which  shows  as  a  white  spot  well  deilned 
against  hvperaemic  surroundings.      Sparking  of  this  kind  causes 
a  smarting,  burning  sensation;  afterwanls  the  sensibility  of  the 
skin  for  further  shocks  rapidly  diminishes.     When  the  discharge 
is  converted  into  a  "quiet"  one,  the  skin  becomes  first  red  and 
then    bluish,   slightly  swollen   and   nedematous.       Sensibility   is 
mostly  altered  in  the  direction  of  analgesia;  sometimes,   how- 
ever, the  re\erse  occurs. 

Exp.  9(5.  A  rabbit,  whose  coat  was  perfectly  fast, 
was  placed  in  a  wooden  reccjitacle  as  before,  and  the 
left  side  of  its  chest  exposed  to  diffused  negative  polar 
discharges  from  the  water-sphere  electrode  VI  at  a  dis- 
tance of  4  cm.     Primary  current,  3  amperes,  i  10  volts, 


1 46  RADIO-  THERAP  Y 

100  interruptions  per  second.  No  earthing  of  the  cur- 
rent. Time  of  exposure,  30  minutes.  No  visible 
sparks  were  evident  during  the  whole  experiment,  and 
the  animal  showed  no  signs  of  discomfort. 

The  treatment  was  continued  in  this  way  for  8  days 
(June  ist-8th).    The  animal,  which  for  want  of  proper 


Fig.  51. 


accommodation  had  to  be  kept  in  a  very  warm 
room,  failed  graciually  in  health  and  died  on  June  8th. 
By  this  time,  however,  changes  w"ere  seen  in  the  fur 
exposed  to  the  discharges;  these  changes  exactly  cor- 
responded to  those  produced  by  direct  spark-discharges: 
thinning  of  the  hair,  bald  spots  in  places  and  clogging 
of  the  woolly  undergrowth  in  others.       (Fig.  51.) 

Exp.  jg.  April  26th.  A  Petri  dish  containing  nu- 
trient agar  is  uniformly  covered  with  a  culture  of  staphy- 
lococcus pyog.  aur.  The  test-tube  electrode  is  fixed  at 
a  distance  of  i  cm.  above  it.  The  apparatus  is  earthed. 
Primary  current, 2  amperes,  1 10  volts;  100  interruptions 
per  second.  No  direct  sparks  are  visible;  a  bluish  halo 
of  "quiet"  discharges  surrounds  the  electrode.  Time  of 
exposure,  25  minutes.  The  Petri  dish  is  afterwards 
placed  in  the  incubator.  April  27th:  The  centre  of  the 
nutrient  agar  shows  a  sterile  circular  patch  the  size  of  a 


HIGH-FREQUENCY  CURRENTS 


147 


kreutzer;  elsewhere  a  thick  uniform  growth  is  seen 
(Fig.  52). 

Exp.  40.  April  26th.  Exp,  39  repeated  without 
the  earthing  of  the  current;  exposure,  35  minutes.  The 
result  was  the  same  as  in  Exp.  39. 

Exp.  41.  May  5th.  l\vo  agar  plates,  A  and  B, 
are  uniformly  inoculated  with  anthrax  bacillus.  A, 
the  control-plate,  is  placed  in  the  incubator;  B  has  its 
central  portion  exposed  to  electrode  VI  and  is  earthed. 
Primary  current,  24  amperes,  iio  volts,  100  interrup- 
tions per  second.  Exposure,  20  minutes,  followed  by 
incubation. 

May  6th.  A  shows  well-developed  colonies;  B 
shows  a  central  sterile  patch  and  colonies  only  round  its 
border. 

Exp.  42.  May  9th.  Plate  A  of  the  preceding  ex- 
periment, now  a  culture  4  days  old,  is  exposed  in  its  cen- 
tral portion  to  the  water-sphere  electrode  for  one  hour; 
the  discharge  is  invisible.  Prom  the  centre  of  A  an  "I" 
is  marked  on  a  second  nutrient  agar  in  dish  B,  while 
from  the  periphery  of  A  a  "11"  is  marked  also  on  B. 


Fig.  52. 


Fig.  53.— Control-plate  A   (Exp.  43). 


May  loth.  Both  marks,  "I"  and  "II,"  on  dish  B 
are  complctcls  and  unitorml\'  covered  with  growth.  The 
discharge  had,  therefore,  been  unable  to  tlcstroy  the  in- 
oculation from  A. 

Exp.  ./^.  May  loth.  'i'wo  agar  plates,  ./  and  B, 
are  coscreti  with  anthrax  bacilli  and  placetl  in  the  incu- 


148  RADIO-THERAPY 

bator.  After  8  hours  R  is  removed;  it  shows  a  sHmy, 
dehcate  Him  throughout  its  surface.  A  cover-glass 
preparation  is  made  from  this  and  stained  with  Moel- 
ler's  carbol  fuchsin-methyhn  bkie,  to  show  the  spores. 
These  and  the  baciUi  are  seen  under  the  microscope  to 
be  very  abundant.  The  central  portion  of  B  is  now  ex- 
posed for  iJ|  hours  to  electrode  \T  (the  water-sphere), 
conveying  quiet  negative  polar  discharges.  Primary 
current,  2  amperes,  iio  volts,  100  interruptions  per  sec- 
ond. Afterwards  an  "I"  from  this  exposed  portion  is 
marked  on  a  third  dish  C,  while  a  "11"  from  its  periph- 
ery (unexposed)  is  marked  also  on  C.  B  and  C  are  then 
placed  in  the  incubator. 

On  the  following  day  A  is  seen  to  be  copiously  cov- 
ered with  colonies.  B  is  seen  to  be  sterile,  with  the  ex- 
ception of  some  scanty  colonies  round  its  border.  7  he 
"I"  on  plate  C  is  only  seen  by  its  furrow;  it  is  quite  ster- 
ile. The  "II,"  on  the  other  hand,  is  well  marked  with 
bacterial  growth  (see  Figs.  53,  54,  55). 
Summing  up  the  results  of  the  last  experiments,  we  see  that 
by  suitable  appliances  we  can  transform  direct  spark-discJiarges 


Fig.  54.  Fig.  55. 

Fig.  54.— Plate  B   (Exp.  43).  Fig.  55.— Plate  C  (Exp.  43). 

into  cjniet  discharges,  zvhereby  they  lose  somezvliat  in  their 
effective  power;  that  in  order  to  make  the  effect  of  these  quiet 
discharges  equal  that  of  direct  sparking  the  exposure  must  be 
prolonged;  that  the  quiet  discharges  from  the  water-sphere 
electrode  have  a  larger  sphere  of  action. 

The  physiological  effects  of  these  quiet  discharges  exactly 


HIGH-FREQUENCY   CURRENTS 


149 


Fig.  56. 


corresponded  with  those  of  direct  spark-discharges:  tlwy  caused 
hair  to  fall  off,  they  prevented  the  development  of  bacteria,  and 
they  destroyed  the  already-developed  colonies  of  anthrax  ba- 
cilli. Electrical  conduction  to  the  ground  was  advantageous 
in  this  instance  as  before. 

Direct  observation  of  the  phe- 
nomena themselv^es  and  comparison 
of  the  effects  of  quiet  discharges  and 
direct  sparking  suggests  the  idea  that, 
just  as  the  thick  shafts  of  sparks 
become  divided  into  several  feebler 
rays,  so  also  the  physiological  effect 
becomes  weakened,  but  on  the  other 
hand  spread  over  a  wider  area.  The 
painlessness  of  quiet  discharges  is 
certainly  a  practical  point  in  their 
favour.  In  using  the  water-sphere 
electrode  it  must  be  very  gradually 
approached  towards  the  object.   The 

author  had  a  special  apparatus  made  for  him  by  Messrs.  Schul- 
meister  &:  Ott,  Vienna  (see  Fig.  56),  which  enables  this  to  be 
attained  very  efficiently. 

Exp.  .j.^.  May  17th.  A  cover-gla^s  preparation 
of  anthrax  bacilli  is  made,  and  the  spores  shown  by 
suitable  staining.  The  microscope  reveals  an  abundant 
culture  of  spore-bearing  bacteria.  A  small  quantity  is, 
therefore,  taken  from  the  culture  and  mixed  with  i 
c.cm.  of  sterile  bouillon.  Fhe  test  tube  containing  this 
mixture  is  placed  for  one  day  in  the  incubator;  typical 
anthrax-colonies  are  seen  to  develop.  Three  drops, 
therefore,  are  taken  of  the  culture  and  placed  in  the  cen- 
tre of  a  sterile  and  empty  Petri  dish.  This  latter  is 
then  exposed  to  direct  sparking  for  15  minutes.  Brush- 
electrode  I  cm.  distance;  earth-conduction;  primary  cur- 
rent, 2  amperes,  i  10  volts,  100  interruptions  per 
second.  After  the  sparking  a  trace  of  the  culture  so 
treated  is  taken  on  a  sterile  platinum  point  and  an  "I" 
drawn  with  this  on  a  sterile  agar  B.     On  the  same  agar 


I50  RADIO-THERAPY 

a  "11"  is  drawn  from  the  non-irradiated  bouillon-culture 
in  the  test  tube.    B  is  then  placed  in  the  incubator. 

May  1 8th.     The  "1"  in  B  is  sterile;  the  "11"  shows 
well-developed  bacteria. 
From  this  experiment  it  follows  that  ?tiicro-organisms,  even 
when  suspended  in   liquids,  are  susceptible  to  the  destructive 
effects  of  spark-discJiarges. 

When  the  conducting  wire  of  a  d'Arsonval-Oudin's  appa- 
ratus in  action  is  observed  in  the  dark,  bluish  rays   (brush-dis- 
charges)  are  seen  to  strike  from  it  at  right  angles  in  its  entire 
length.      The  rays  are  very  similar  to  those  of  our  water-sphere 
electrode,  and  they  evoke  similar  sensations  in  the  skin.       In 
order  to  discover  if  these  rays  were  the  cause  of  the  well-known 
phenomenon — the  illumination  of  an  incandescent  lamp  placed 
within  (but  not  in  contact  with)  a  metallic  spiral  traversed  by 
high-frequency  currents — the  following  experiment  was  made: 
Exp.  ^5.     Within  such  a  spiral  a  large  pasteboard 
cylinder   was   placed,    covered   above   and   below   with 
glass  plates.      Within  this  cylinder  two  spirals  of  wire 
with    an    incandescent    lamp   between    them    were    sus- 
pended.     As    soon    as    high-frequency    currents    were 
sent  through  the  solenoid  the  lamp  began  to  shine.   Since 
thick    pasteboard,     such     as     was     used     in     this     in- 
stance, prevents  the  passage  of  brush-discharges  (as  the 
author  had  proved  by  other  experiments),  we  had  clear- 
ly   to    deal    here    with    an    induction-effect    within    the 
cylinder. 

The  question  now  arose,  had  this  inductive  action 
any  role  in  the  destruction  of  germs  by  high-frequency 
currents  ? 

Exp.  ^6.  Diffused  cultures  of  staphylococcus  pyog. 
aur.  are  made  on  two  nutrient  agars  (with  sloping  sur- 
faces) contained  in  test  tubes.  Culture  A  is  for  con- 
trol purposes.  Tube  B  is  wound  round,  opposite  the 
agar,  with  four  turns  of  thick  insulated  copper  wire. 
The  ends  of  this  wire  are  attached  to  the  first  and  last 
winding  respectively  of  a  d'Arsonvnl's  solenoid  D. 

D'Arsonval  states  that  within  a  spiral  of  this  de- 


HIGH-FREQUENCY   CURRENTS 


151 


scription  sufficient  heat  is  developed  to  boil  mercury  in 
the  bulb  of  a  thermometer.  Consequently  the  spiral 
and  test  tube  are  placed  in  a  vessel  of  ice-water.  The 
apparatus  is  then  set  working  and  the  culture  in  the 
test  tube  exposed  for  45  minutes  to  the  action  of  high- 
frequency  currents. 

A  mercury-thermometer  immersed  in  the  tube  regis- 
tered 10°  C.  throughout  the  experiment.  After  the 
exposure  of  the  tube  in  this  way  both  A  and  B  were 
placed  in  the  incubator. 

On  the  following  day  both  agars  were  found  thickly 
and  uniformly  co\  ered  with  colonies. 

The  experiment  showed  that  high-freqtiency  cur- 
rents have  no  bactericidal  effect  zvJiicli  can  he  referred 
to  induction. 

Exp.  ~fy.     In  order  to  examine  the  action  of  spark 
discharges  on  the  blood-vessels  a  frog  was  curarised.    A 
fold  of  mesentery  was  then  arranged  over  a  perforated 
cork — as  is  done  in  examinations  of 
the  blood-circulation — and  exposed 
to     the     direct     discharges     from 
apparatus  /.    Under  the  microscope 
a  v^essel  was  seen,  from  which  the 
diagrammatic  sketch    (Fig.  57)    is 
taken.  Afissure  (Schl.)  is  seen  in  the 
front    and    hinder    walls    of    the 
vessel;  the  direction  of  this  fissure  is 
perpendicular  to  that  of  the  path 
of  the  discharge.    The  walls  of  the 
vessel  must  in  some  way  have  become  fused  together 
round  the  fissure,  for  no  signs  of  extravasation  were  to 
be  seen.     The  diverted  course  of  the  blood-stream  is 
shown  in  the  sketch,    l^his  condition  obtained  for  nearly 
48  hours. 
In  order  to  examine  the  histological  changes  which  take 
place  in  living  skin  exposed  to  spark-discharges,  Exp.  48  was 
undertaken.     A  rabbit  was  amesthetised  and  a  portion  of  its 
skin   treated    for  3     minutes    to    the    powerful    sparks    from 


jS^cji^. 


Fig.  57. 


152  RADIO-THERAPY 

apparatus  /,  using  the  negative  polar  current.  A  second  por- 
tion of  the  skin  was  exposed  to  sparks  from  apparatus  II,  and  a 
third,  for  the  same  time,  to  the  effluvia  of  a  d'Arsonval-Oudin's 
apparatus.  Although  the  animal  was  deeply  anaesthetised, 
breathing  but  superficially  and  showing  no  conjunctival  reflex, 
it  responded  instantly  to  the  first  spark-discharge  and  made  ef- 
forts to  escape.  The  prompt  appearance  of  these  stimulating 
effects  of  high-tension  induced  current  discharges  is  a  point  of 
practical  significance. 

After  the  experiment  small  extravasations  of  blood  were 
seen  on  both  portions  of  the  skin  which  had  been  exposed  to 
spark-discharges.  The  animal  soon  recovered  from  the  effects 
of  the  chloroform  and  appeared  quite  healthy.  A  day  later 
it  was  killed,  and  the  exposed  portions  of  its  skin  deeply  excised 
and  prepared  for  microscopic  examination. 

(c)    Histological  Investigations. 

The  specimens  of  skin  were  hardened  in  Mueller  formol, 
embedded  in  celloidin,  and  cut  at  right  angles  to  the  surface. 
Horizontal  sections  were  made  of  the  piece  which  had  been 
treated  by  the  discharges  from  apparatus  //.  The  sections 
were  stained  with  haemalum-eosin,  ha^motoxylin-eosin,  poly- 
chrome methylene-blue,  and  also  after  the  methods  of  Tdnzer- 
Unna,  IFeigert  and  van  Giesson.  Specimens  of  skin  which  had 
not  been  subjected  to  the  experiments  were  similarly  prepared 
for  purposes  of  comparison. 

Examination  even  by  low  power  showed  that  changes  had 
occurred.  These  changes  were  localised  in  the  upper  layers  of 
the  skin  in  the  form  of  a  focus;  with  increasing  depth  they  were 
spread  out  over  a  gradually  increasing  area. 

In  the  stratum  mucosum  a  cell-infiltration  appeared,  which 
contrasted  well  with  its  surroundings  (see  Fig.  58) .  This  small 
cell  infiltration  separated  the  cellular  tissue  of  the  rete 
malphigii,  partly  taking  the  place  of  the  latter  in  both  its  upper 
and  lower  layers.  The  infiltration  consisted  entirely  of  poly- 
nuclear  leucocytes,  thickly  clustered  in  the  upper  layers  and  here 
hardly  distinguishable  from  each  other,  while  in  th.e  lower  lay- 


HIGH-FREQUENCY  CURRENTS 


153 


ers  of  the  infiltration  the  cells  could  be  readily  defined,  and  were 
seen  to  contain  numerous  eosinophile  granules  in  their  proto- 
plasm. 

Further  important  changes  were  found,  at  varying  depths, 
in  the  pars  papillaris  and  pars  reticularis.      Here,  even  with  the 


W^^M'^'  ^^ 


MM 


iS 


Fig.  58. 


low  power,  an  infiltration  with  red  blood-corpuscles  was  evi- 
dent; this  filled  the  interstices  of  the  tissue  in  the  form  of 
streaks,  and  surrounded  the  hair-follicles  like  a  web.  I'his  was 
plainly  shown  in  the  horizontal  sections  of  specimen  //.  The 
infiltration  was  evidently  a  hemorrhage  into  the  cuticular  tis- 
sues. 


154 


RADIO-THERAPY 


Here  and  there  on  the  surface  of  the  epidermis  were  crusts 
of  necrotic  material;  cell  elements  were  visible  here  also,  which 
proved  to  be  red  corpuscles. 

Still  more  striking  were  the  conditions  obtaining  in  the  blood- 
vessels. A  casual  inspection  even  showed  marked  vascular 
dilatation,  the  veins  especially  being  widely  dilated  and  gorged 
with  blood.  These  vascular  changes  were  more  marked  in  the 
deeper  layers  of  the  corium. 

The  vessel  walls  showed  especial  changes  in  the  case  of  the 
arteries  (Fig.  59).  In  some  of  these  the  intima  appeared  so 
thickened  that  it  occupied  the  greater  part  of  the  lumen.      In 

the     intima     and     media 
3  peculiar       round       spaces 

(vi)  the  size  of  a  cell- 
nucleus  were  visible;  these 
spaces  were  packed  to- 
gether (14  or  more  being 
seen  in  some  sections), 
'^  partly  raising  the  intima 
from  its  underlying  layer, 
so  that  it  was  only  con- 
nected by  septa  with  the 
rest  of  the  vessel-wall. 
Examination  by  the  high 
power  showed  that  the 
spaces  were  not  really 
formed  by  the  raising  of 
the  intima  from  the  elas- 
tica,  but  by  vacuole  degeneration  of  the  cells.  They  are,  moreover, 
not  arranged  purely  concentrically,  but  quite  irregularly,  being 
here  adjacent  to  and  there  remote  from  the  vessel  lumen.  The 
spaces  (vacuoles)  were,  as  has  been  said,,  also  visible  in  the 
media  (vm),  but  to  a  less  extent.  The  formation  of  vacuoles 
to  the  extent  just  described  was  only  seen  in  a  few  sections;  most 
sections  showed  only  two  or  three  vacuoles. 

The  nuclei  of  some  of  the  cells  within  the  vicinity  of  the 
vacuoles  possessed  a  peculiar  property.  Whereas  the  nuclei  of 
other  cells  took  the  stain  readily  and  appeared  finely  granulated 


652 
I 

Fig.  59. 


HIGH-FREOUEXCY  CURRENTS  155 

and  dark,  these  nuclei  remained  light-coloured  and  homogene- 
ous, showing  no  traces  of  granules,  but  rather  having  the 
appearance  of  drops  of  oil  or  water.  Where  nuclear  granu- 
lation was  seen  this  was  coarser  and  more  marked  than  that  of 
the  cell-protoplasm.  The  granules  were  mostly  arranged  at  the 
periphery,  leaving  the  centre  clear,  with  perhaps  several  vacu- 
oles there  situated. 

Many  cell-nuclei  in  the  hair  root-sheaths  showed  similar 
peculiarities.  Many  of  the  hair-sheaths  were  empty;  a  few 
still  contained  hair,  and  in  these  no  abnormality  could  be 
observed. 

Pigment  was  formed  in  clumps  in  parts  of  the  upper  cuticu- 
lar  layers;  it  did  not  appear  to  be  increased  in  quantity.  In 
the  sections  stained  with  orcein,  according  to  Tiinzer-Unnas 
method,  elastic  fibres  were  visible  amongst  the  connective  tissue, 
both  of  the  pars  papillaris  and  pars  reticularis.  Where  the 
haemorrhages  obtained,  these  fibres  were  sometimes  pressed 
apart  from  one  another  and  destroyed.  Mast-cells,  plasma- 
cells,  and  giant-cells  were  not  seen  in  any  specimen. 

Summed  up,  microscopical  examination  revealed  mainly 
{a)  small-celled  infiltration  in  the  deeper  layers  of  the  epi- 
dermis, {b)  extensive  extravasation  of  blood,  {c)  vacuolisation 
in  the  intima  of  the  arterioles. 

Comparing  these  facts  with  what  Gassmann  observed  in  a 
case  of  Roentgen-dermatitis,  we  are  first  struck  by  the  similarity 
in  the  condition  of  the  vessel  walls  in  both  instances.  Ultra- 
violet light,  moreover,  as  Glebowsky  proved,  produces  similar 
changes  in  the  cell-protoplasm.  There  can  be  no  doubt  that  in 
our  case  these  changes  may  be  ascribed  to  the  electric  discharges; 
this  was  proved  by  comparison  with  sections  of  skin  which  had 
not  been  so  treated.  Moreover,  only  those  vessels  which  were 
within  the  range  of  the  discharges  were  affected;  other  vessels 
in  the  same  preparation  were  free  from  change. 

The  author  cannot  decide  whether  the  vacuolisation  must  be 
considered  as  due  to  the  direct  mechanical  action  of  the  sparks, 
or  whether  it  is  a  degeneration  caused  by  electricity  itself;  the 
latter,  however,  appears  to  him  to  be  more  probable. 

A  second  important  change  in  the  exposed  skin  is  repre- 


156  RADIO-THERAPY 

sented  by  the  hsemorrhage.  It  is  quite  possible  that  this  phe- 
nomenon may  bear  some  relation  to  the  marked  pigmentation 
following  Roentgen-radiation;  that  is  to  say,  the  electric  dis- 
charges from  the  Roentgen-tube  may  cause  haemorrhage,  fol- 
lowed by  the  deposit  of  haemosiderin. 

The  above-described  transformations,  sometimes  more 
marked  in  one  respect  than  in  the  others,  were  seen  in  all  the  sec- 
tions made  from  the  three  portions  of  skin  which  had  been 
treated  by  discharges  from  different  apparatus.  We  may  as- 
sume, therefore,  that  high-tension  discharges,  of  whatever  ori^ 
gin,  produce  physiological  effects  which  are  identical  as  regards 
their  quality  and  differ  only  in  their  intensity. 

Many  authors  state  that  not  only  the  cells  of  vessel  walls, 
but,  under  certain  circumstances,  other  structures  are  trans- 
formed in  like  manner. 

Thus,  on  reviewing  the  literature  of  the  subject  we  find  that 
several  botanists  speak  of  the  disorganisation  of  protoplasm 
under  the  influence  of  electricity.  Klemm^)  mentions  swelling 
of  the  protoplasmic  layers  and  fibres  and  plentiful  production 
of  vacuoles  of  an  indefinite  size.  Pfeffcr-)  states  that  the  nu- 
clei are  more  sensitive  to  electrical  influence  than  the  unformed 
protoplasm.  In  the  case  of  tradescantia  the  nucleus  swells  al- 
most to  twice  its  original  size,  becomes  circular,  and  then  sud- 
denly collapses  and  becomes  irregular  in  its  outline;  it  often 
takes  a  stain  before  the  body  of  the  cell  colours  at  all. 

Kuehne  ^)  and  Ferzvorn  *)  observed  that  the  galvanic  cur- 
rent produces  granular  decay  in  the  protoplasm  of  actinos- 
pharium,  mycomycelis,  polystonella  and  pelomyxa.  Verworn 
traces  the  opacity  and  shrinking  of  the  protoplasm,  which  is 
"typical  of  contractor-excitement,"  to  a  very  fine  vacuolisation 
(becoming  froth-like  and  honeycombed)  of  the  homogeneous 
hyaline  condition  which  previously  obtained  in  the  protoplasm. 


')  Jahrb.  f.  wissensch.  Bot..  1895,  Vol.  XXVIIT.  p.  627. 

')  Abh.  d.  Saechs.  Ges.  d.  Wiss.,  Nw.-math.-ph.  Cf..  Vol.  XVI.  p.  185. 

')  Arch.  f.  Anat.  und  Phys.,  1859,  pp.  564  and  748.— Unters.  ueber  das 
Protoplasma,  Leipzig,  Engelmann. 

')  Arch.  f.  d.  ges.  Physiol.,  Vol.  XLV..  p.  1,267;  Vol.  LXV,  p.  47,  and 
Sitzs.  der  Berl.  phys.  Gesellsch.,  Dub.  Arch.,  1894,  P-  538. 


HIGH-FREQUENCY  CURRENTS  157 

He  also  observed  granular  destruction  of  the  protoplasm  re- 
sulting Ironi  alternatmg  currents. 

Ronx'^)  found  that  alternating  currents  caused  migration 
of  pigment  in  frog-spawn,  and  contractions  so  powerful  that 
the  ova  became  broken  and  the  yolk  escaped. 

C.  Ht'ss-)  explains  the  opacity  of  the  lens  which  occurs 
after  a  lightning-stroke  by  the  destruction  of  ephithclium  in  its 
capsule. 

K.  Kirlbiichi  ')  exposed  rabbits'  eyes  to  powerful  spark-dis- 
charges. He  found  both  in  the  protoplasm  and  the  nuclei  of 
the  capsular  epithelium  a  formation  of  vacuoles,  which  he  as- 
cribed to  electrolytic  processes. 

All  these  reports  go  to  show  that  the  damage  caused  to 
protoplasm  bv  electricity  consists  of  a  loss  of  cohesion  and  a 
solution  of  its  ingredients,  which  is  probably  brought  about  by 
chemical  transformation  (vacuolisation) . 

Several  authors  describe  changes  in  the  nerve-cell  from  elec- 
trical stimulation.  These  changes  are  visible  under  the  micro- 
scope, or  show  themselves  in  the  form  of  "fatigue." 

Korybiit-Daskiewicz  ^)  found  an  enlargement  of  the  nuclei 
in  the  cells  of  the  medulla  which  are  in  connection  wnth  the  elec- 
trically-excited nerves. 

Hodge  ^)  found  reduction  in  the  size  of  the  nucleus,  vac- 
uolisation of  the  protoplasm,  and  lessened  staining  power. 

Magitii'')  found  disappearance  of  the  nucleoli  and  a  better 
staining  capacity  in  certain  cells  of  the  anterior  cornua. 

J'as')  observed  swelling  of  the  nucleus  and  the  cell-body, 
also  dispersion  of  the  nucleus  and  the  chromatic  substance 
towards  the  periphery  of  the  cell.     I .(iiuhi'vt's  ^)    observations 


')  Sitzungsh.  d.  k.  Akad.  d.  Wiss..  Math.  Nat.  Classc.  Abth.  Ill,  1891, 
Vol.  CI    p.  27.  and  Pflue.^cr's  Arch.,  1896,  Vol.  LXIII. 

')    Ber.  ophtlialni.   Congr.  Hcidclbc-rg,   188S. 

')   V.  Gvacfc's  .Arch.  f.  Ophthalm..  L.  I.,   igoo. 

')   Arch.  f.  niikro^k.  Anat.,  1889,  p.  3i- 

'•)  American  Journal  Psych..  Vol.  II,  p.  3/8:  Vol.  Ill,  p.  530 :  Journal  of 
Morphology,  Vol.  IX.  j),  449. 

*)    Compt.  rend,  du   II.  cong.   intern.   Vol.   II    (Phy.siology),  p.    104. 

')   Arch.  f.  mikrosk.  Anat.  Vol.  XI..  p.  375- 

')   Compt.  rend,  de  la  Soc.  dc  Biologic.  Paris,   1893,  p.  879. 


158  RADIO-THERAPY 

agree  with  those  of  Vas.  Mann  ')  found  that  the  size  of  the 
cell,  the  nucleus,  and  the  nucleolus  increases  during  the  stage  of 
irritation,  and  that  the  chromatic  matter  is  destroyed.  In  the 
stage  of  fatigue  the  size  of  the  nucleus  diminishes  and  its  stain- 
ing becomes  more  diffuse.  Liigaro's'-)  observations  agree  with 
this,  f'alenza")  found  that  after  prolonged  irritation  of  the 
electric  organ  of  the  torpedo-lish  by  high-tension  and  high-fre- 
quency currents  important  retrogressive  changes  occurred  in  the 
nerve-cells.  These  were  shown  especially  in  the  nuclei  as 
"chromatolysis  caryorixe"  and  as  hyperchromatosis.  When  the 
cells  were  adjacent  to  the  electrode  the  nuclei  contracted  with 
irregular  outlines  and  hyperchromatosis  of  its  contents;  the  nu- 
cleoli, moreover,  became  absent.  Parts  more  remote  from  the 
electrode,  however,  showed  an  increase  in  the  volume  of  the 
nucleus,  hyperchromatosis  of  the  nuclear  wall  alone,  while  the 
nucleolus  still  remained  in  evidence.  By  the  application  of 
less  powerful  currents  he  found  various  changes  in  the  nerve- 
cells. 

G.  Corrado  *)  killed  dogs  by  the  direct  application  of  high- 
potential  currents  (400-920  volts,  10-23.5  amperes).  The  cur- 
rent was  applied  through  broad  metallic  electrodes,  one  of 
which  was  attached  to  the  forehead  and  the  other  to  the  back, 
near  the  animal's  tail.  With  the  highest  tension  he  observed 
spark-shocks  at  the  site  of  the  electrodes,  but  there  was  always 
also  a  certain  amount  of  burning  without  the  formation  of 
sparks.  The  autopsy  revealed  congestion  of  the  meninges,  the 
sinuses  of  the  dura  mater  being  engorged  with  blood.  Often 
effusions  of  blood  would  be  seen  on  the  surface  of  the  cerebrum, 
and  on  one  occasion  there  was  hasmorrhagic  effusion 
into  the  lateral  ventricles.  On  the  surface  of  the  medulla  ob- 
longata numerous  ecchymoses  were  found.  The  heart  in  most 
cases  was  in  a  state  of  systole,  especially  the  left  ventricle.  In 
one  case  bubbles  of  gas  were  found  in  the  blood,  in  another 


')   Journ.  of  Anatomy  and  Physiology,  Vol.  XXIX,  p.   100. 
')   Lo  Sperimentale  a  49,  sect,  biolog.,   Florence.   1895,  p.   159. 
*)   Atti  della  R.  Accad.  d.  Sc.  fisiche  e  nat.  di  Napoli,  Vol.  VIII.  ser.  2. 
*)   Ann.   d'electrobiol.,  Vol.   II,   1899,  p.  245.     The  experiments  made  by 
this  author  are  very  similar  to  those  printed  later  by  S.  Jcllinck. 


HIGH-FREQUENCY  CURRENTS  159 

they  were  in  the  meninges  of  the  medulla,  while  in  a  third  case 
they  occupied  the  cerebral  fissures. 

Corrado  described  in  the  first  place  marked  alterations  in  the 
body  of  the  nerve-cells.  Many  nerve-cells  could  be  recognised 
through  Golgi's  method  of  staining,  or  by  convergence  of  nerve 
fibres  towards  them.  Most  of  them  appeared  globular,  irreg- 
ular, or  torn.  By  other  methods  of  staining  (<?.  g.,  Nissel's) 
the  fragments  of  the  lacerated  cells  were  also  discernible;  often 
the  protoplasm  near  the  well-preserved  nucleus  appeared  gran- 
ular. The  condition  was,  therefore,  one  of  cytorrhexia.  The 
cells  of  the  spinal  marrow  were  less  affected  than  those  of  the 
cerebrum.  In  certain  of  the  microscopic  fields  cells  could  be 
seen  which  were  absolutely  normal,  in  addition  to  those  which 
were  badly  damaged.  Often  a  cell  had  the  appearance  as 
though  parts  of  the  protoplasm  had  been  expelled  from  one 
side. 

In  the  cell-body  Corrado  found  a  removal  of  the  chromatic 
substance,  a  homogeneous  powder-like  condition ;  in  a  word, 
marked  plasmolysis.  Often  distinct  vacuolisation  was  observed. 
The  chromatic  substance  showed  a  tendency  to  separate  itself 
from  the  remainder  of  the  cell-body  and  to  congregate  at  one 
side  of  the  cell,  the  other  side  remaining  uncoloured.  {Cor- 
rado believes  that  the  situation  of  the  decolourised  portion  indi- 
cates the  direction  of  the  current.)  In  most  cases  the  nucleus 
appeared  changed  only  In  its  general  aspect  and  in  its  volume — 
its  outlines  were  angular  and  irregular.  The  chromatic  sub- 
stance of  the  nuclei  was  either  completely  destroyed  or  left  a 
few  thready  remnants  near  the  periphery.  The  situation  of  the 
nucleus  in  the  cell-body  varied,  but  was  generally  somewhere 
near  the  circumference  of  the  cell,  especially  at  that  side  where 
the  chromatic  substance  had  collected.  The  nuclear  membrane 
was  sometimes  torn.  1  he  nucleolus  was  generally  uninjured, 
and  stained  well.  Sometimes,  h()we\'cr,  it  was  destroyed;  it 
changed  its  situation,  tra\  ersctl  the  nuclear  membrane,  and  ar- 
ri\-ed  at  the  perij)hery  of  the  cell. 

The  processes  of  the  ner\e-cells  often  showed  a  condition 
of  "varicose  atrophy."  They  were  throughout  fragmentary 
and  disarranged.      Not  infre(]ucnt1y  a  spiral  ami  highly  char- 


i6o  RADIO-THERAPY 

acteristic  condition  was  to  be  found  in  the  protoplasmic  processes 
of  the  pyramid  cells  in  the  cortex.  Corrado  believes  that  there 
is  not  only  a  chemical  but  also  a  mechanical  action  on  the  nerve- 
cells;  moreover,  the  bubbles  of  gas  are  evolved  in  the  Interior 
of  the  cells,  as  in  the  meninges  and  the  blood. 

iS.  JcUiuck^)  observed  that  ganglion-cells  in  the  spinal-mar- 
row burst  and  ecchymosis  also  resulted  after  the  use  of  power- 
ful alternating  current-discharges. 

Light  has  been  shed  on  the  mechanics  of  the  effects  of  spark- 
discharges  partly  by  direct  observation  of  Irradiated  cultures, 
partly  by  microscopical  Investigation  of  the  condition  of  the 
exposed  skin.  Short  exposures  produced  an  Immediate  drying 
effect  on  the  Inoculated  nutrient  mecllum;  after  longer  exposure 
heat-effects  were  noticed — the  nutrient  medium  became  brown- 
coloured,  swollen,  and  fluid.  With  sparking  at  a  rapid  rate,  a 
small  flame  flasheci  up  from  time  to  time,  vapours  arose,  and  the 
sound  of  the  boiling  agar  was  to  be  heard. 

It  is  quite  comprehensible  that  these  two  factors  alone 
(desiccation  and  heat)  would  be  sufficient  to  cause  destruction 
of  bacteria  and  perchance  therapeutic  effects  also.  Possibly 
marked  desquamation — the  result  of  desiccation,  and  perhaps 
also  of  the  electrolytic  destruction  of  the  superficial  layers  of 
cells  in  the  skin- — -may  explain  any  good  results  achieved  In  the 
case  of  acne,  seborrh(Ea,  and  similar  affections.  Both  desicca- 
tion and  rise  of  temperature  are  inimical  to  the  vegetative  forms 
of  bacteria.  Even  the  spores  which  longer  resist  such  dele- 
terious influences  may  be  destroyed,  as  the  author  has  proved, 
by  spark-discharges  from  suitable  apparatus. 

Tesla  explained  the  heat-effects  of  high-frequency  current 
as  follows:  A  body,  properly  Insulated  in  the  air,  becomes 
heated  simply  by  connecting  It  with  a  source  of  rapidly-alter- 
nating high-tension  electricity.  The  body  becomes  heated  by 
its  electrical  bombardment,  through  the  air  or  through  any 
medium  of  a  molecular  or  atomic  constitution.  I  he  bodv  Itself 
may  be  a  good  or  a  bad  conductor;  this  does  not  materially  affect 
the  heat  phenomenon.      The  human  body  happens  to  be  a  good 


^)   Wiener  klin.  Wochenschr.,   1902,  p.  450. 


HIGH-FREQUENCY  CURRENTS  i6i 

conductor;  when  a  person  standing  insulated  in  a  room  comes 
into  contact  with  a  generator  of  high-frequency  currents  his 
skin  becomes  heated  by  the  electrical  bombardment.  The  ex- 
tent of  the  calorific  effect  depends  upon  the  dimensions  and  gen- 
eral arrangement  of  the  apparatus. 

The  physiological  effects  (e.  g.,  lessened  sensibility)  may 
also  reasonably  be  ascribed  in  part  to  "mechanical  concussion/' 
the  mechanical  action  of  the  rapid  bombardment  on  the  tissues. 

Besides  these  factors  we  have,  however,  to  consider  still  oth- 
ers; this  was  shown  by  the  author's  histological  examination  of 
skin  treated  by  spark-discharges.  Where  the  discharges  had 
only  operated  for  a  short  time,  and  had  been  produced  by  weak 
currents,  merely  superficial  inflammation  and  small-celled  infil- 
tration was  discernible  in  the  upper  layer  of  the  cutis.  When, 
however,  powerful  and  rapidly-succeeding  sparks  had  been  in 
operation  for  a  considerable  time,  very  marked  alterations  were 
produced  in  the  tissues. 

According  to  Engelmann,  Klemen,  Davenport  and  others, 
these  changes  consisted  in  an  impairment  of  cohesion  and  a  so- 
lution of  the  cell-ingredients  (vacuolisation)  ;  the  latter  effect  is 
probably  brought  about  by  chemical  change,  the  former  more 
indirectly.  Electrolytic  processes  can  be  readily  understood 
to  be  going  forward  in  the  cells,  and  these,  acting  in  concert 
with  the  local  increase  of  temperature,  may  conceivably  hinder 
the  development  of  micro-organisms. 

Physiological  investigation  thus  shows,  ist,  that  spark-dis- 
charges of  whatever  origin  may  induce  desiccation ;  2nd,  heat- 
effects;  jrd,  that  by  these  means  the  development  of  bacteria 
may  be  hindered;  4th,  that  in  all  probability  an  electrolytic,  and 
^th,  a  mechanical  action  are  to  be  ascribed  to  them.  We  must 
also  bear  in  mind  the  possible  action  of  the  actinic  light-rays 
(blue,  violet,  ultra-violet)  which  accompany  the  sparking  phe- 
nomena, the  freely-developed  ozone,  and  the  remote  effects  of 
the  electric  waves  themsches. 

It  is  theoretically  possible  that  by  means  of  the  local  action 
on  the  skin  indirect  effects  may  be  attained  on  the  whole  organ- 
ism. The  passixc  hypera-mia  induced  on  the  body  surface 
might,  were  a  sufficiently  large  area  treated  at  once,  result  in  the 


1 62  RADIO-THERAPY 

relief  of  congestion  in  deep-lying  organs.  Thus  in  the  case  of 
d'Arsotival's  method  of  auto-conduction,  could  it  be  proved  that 
really  efficacious  high-tension  discharges  take  place  between  the 
solenoid  and  the  body  of  the  patient  (and  the  author  himself 
has  never  been  able  to  verify  this),  one  would  be  the  better 
able  to  understand  the  beneficial  effects  claimed  for  this  method. 

The  same  physiological  effects  on  the  skin  can  be  obtained 
by  the  use  of  strong  discharges  from  a  static  machine,  or  from  a 
Roentgen  apparatus.  If  these  act  on  a  large  surface  of  the  body 
for  a  considerable  time  one  may  also,  for  the  above-stated  rea- 
sons, expect  some  effect  upon  the  general  organism.  In  this 
sense  the  action  of  these  electrical  methods  of  treatment  is  prob- 
ably comparable  with  that  of  hydro-therapeutics  and  light-treat- 
ment. Each  aims  at  a  local  Irritation  of  the  skin.  The  thera- 
peutic effects  of  faradic  currents  are  probably  also  to  be  ex- 
plained in  this  way;  here  also  we  are  dealing  with  the  dis- 
charges of  induced  currents,  albeit  very  weak  ones,  applied  to 
the  skin. 

As  regards  the  remote  (electrolytic)  effects  of  high-fre- 
quency discharges,  these  are  probably,  on  account  of  the  low 
intensity  of  the  currents  employed,  inferior  to  those  produced 
by  the  employment  of  direct  spark  of  brush-discharges  at  the 
exposed  surface. 

Arguing  from  the  results  of  his  own  experimental  and  his- 
tological enquiries,  and  comparing  these  with  the  findings  of 
other  investigators,  the  author  came  to  the  following  conclu- 
sions regarding  the  mode  of  action  of  electricity: 

There  is  no  hard  and  fast  line  to  be  drawn  between  the  bio- 
logical effects  of  statical,  faradic,  and  high-frequency  electricity. 
Any  differences  which  may  exist  depend  simply  upon  the 
strength  of  current  employed  in  any  particular  instance.  The 
effects  are  mechanical,  electrolytic,  and  thermic;  the  most  im- 
portant action  of  electricity  on  the  tissues  is  to  be  found  in  its 
disorganisation  of  living  protoplasm  (vacuolisation  degener- 
ation). When  the  electrical  discharges  are  of  high  intensity 
the  effect  will  be  manifested  not  only  at  the  site  of  their  appli- 
cation, but  also  in  remoter  regions  of  the  body  to  which  the 
current  has   been   conveyed.      Thus  In   addition   to   local   cell 


HIGH-FREQUENCY  CURRENTS  163 

destruction  at  the  site  of  impact  we  may  get  disorganisation  in 
the  cell-tissue  of  more  remote  \ital  parts  (as  in  death  from  cur- 
rents from  the  main  or  from  lightning,  where  we  may  get  haem- 
orrhages into  the  tissues  of  the  central  nervous  system  in  addi- 
tion to  local  effects  at  the  part  struck).  When,  however,  the 
intensity  of  the  current  is  low,  the  effects  are  merely  local,  pro- 
ducing anatomical  changes  in  the  skin  and  nerve  fibres,  though 
sometimes  functional  effects  (convulsions)  may  also  be  pro- 
duced. Further  histological  investigations  are  required  before 
it  can  be  decided  whether  the  good  results  claimed  for  the  treat- 
ment of  internal  diseases  by  the  application  of  electricity  which 
possesses  no  great  intensity  are  to  be  ascribed  to  the  direct  influ- 
ence of  that  electricity  on  deep-lying  organs,  or  to  the  local  irri- 
tation of  superficial  tissues  (the  skin,  the  sensory  nerves)  where- 
by secondary  changes  (depletion,  nervous  reflexes,  etc.)  are 
evoked  in  deeper  parts.  The  author  himself  inclines  to  the 
latter  view. 

The  author  believes  that  the  local  Irritation  of  the  nerve- 
terminals  by  electrical  discharges  plays  a  considerable  part  in 
ordinary  electro-therapy.  It  appears  to  him  very  unlikely  that 
ordinary  faradic  induced  currents  of  low  intensity  can  have  any 
influence  on  remote  organs,  even  If  it  be  presumed  that  they 
are  conv^eyed  to  those  organs  along  the  nerve  trunks.  But  the 
strong  local  action  of  alternating-current  discharges  as  applied 
by  the  brush-electrode  must  be  regarded  as  therapeutically  im- 
portant; this  action  may  be  compared  with  that  of  chemical  irri- 
tants, though  it  Is  possibly  more  pow'erful  than  that  of  the 
latter.  The  application  of  constant  galvanic  currents,  how- 
ever, If  these  be  of  fair  Intensity,  must  have  some  derivative 
effect;  at  the  site  of  the  electrodes  considerable  electrolytic 
action  and  signs  of  irritation  In  the  superficial  tissues  are  mani- 
fest. The  latter  show  themselves  by  more  or  less  marked  ery- 
thema,  often  followed  by  pigmentation.  If  a  powerful  galvanic 
current  be  passed  through  the  tissues  It  may  produce  marked 
destructive  changes.  Conceivably  by  these  diseased  tissues 
fibres  or  cells  might  be  destroyed,  and  so  prepared  for  absorp- 
tion. 

The  abo\e  considerations  may  3erve  to  explain  the  goo^ 


1 64  RADIO-THERAPY 

effects  of  faradic  brush-applications  in  cases  of  neuralgia,  etc., 
of  galvanic  treatment  in  cases  of  painful  or  tender  regions  in 
the  spine. 

The  shocks  produced  by  current-interruptions  are  certainly 
of  importance  in  a  therapeutic  sense.  Any  sudden  disturbance 
of  the  electrical  equilibrium  of  the  body  probably  acts  physio- 
logically. In  this  way  also  the  body  may  be  possibly  affected 
by  being  placed  in  any  field  of  electric  vibrations.  Undoubt- 
edly the  sudden  opening  and  closing  of  currents  acts  as  a  pow- 
erful stimulus  on  nerve  terminals;  this  may  be  transmitted  along 
nerve  trunks  to  the  muscles,  and  so  excite  contraction.  It  would 
appear  quite  reasonable  to  apply  this  property  of  electrical,  and 
especially  faradic,  currents  to  medical  purposes. 

Many  authors  have  proved  that  electric  vibrations  produce 
certain  effects  on  living  tissues.  B.  J.  Danilcwsky  ^)  showed 
by  a  series  of  experiments  that  many  tissues  and  organs  (nerves, 
muscles,  the  brain,  the  organs  of  sense,  protoplasm  in  general) 
are  affected  when  placed  within  an  electric  field,  even  when  the 
electric  source  is  some  distance  from  the  organism  and  not  in 
direct  connection  therewith.  This  inductive  action  undoubtedly 
exists  also  in  the  case  of  an  organism  placed  in  a  field  of  atmos- 
pheric electricity.  Electrical  waves  or  rays  cause  physiological 
effects  even  at  considerable  distances,  and  partition  walls  of 
wood  or  even  stone  cannot  prevent  these  manifestations.  The 
physiological  effect  shown  by  increased  irritability,  restlessness, 
or  a  feeling  of  oppression,  according  to  the  intensity  of  the  elec- 
trical action  and  the  circumstances  under  which  it  is  produced. 
In  all  these  instances  the  essential  condition  of  electric  stimula- 
tion is  the  oscillatory  character  of  the  electric  field. 

Radzikoivsky,"^)  Chatzky,^)  Knrella,^)  and  others  have 
made  similar  observations.  Capriati')  obtained  in  this  way 
(through  the  agency  of  the  electric  field)    an  influence  on  the 


')   Centralb].   f.   Physiologie,  XI,   No.   19,  20.     See  also  Compt.   rend,   du 
XII  Congr.  intern.,  Moscow,  Vol.  II,  Section  II,  p.  59. 

")   Quoted  by  6".  Jcllinck,  Wr.  klin.  Wochenschr.,  1902,  p.  450. 

^)   Zeitschr.   f.   Elektrotherapie  u.  aerztliche-Elektrotechnik,  June,   1900. 

')   Ibid. 

^)   Ibid. 


HIGH-FREQUENCY  CURRENTS  165 

development  of  tadpoles;  while  Selim  Ecmstroevi  ')    and  Bti- 
thelot  -)  observed  an  effect  on  the  growth  of  plants. 

The  detailed  account  given  of  the  foregoing  experiments 
shows  that  d' J rsoiival-Oudin' s  apparatus  owes  its  efficiency 
mainly  to  the  actiun  of  spark-disc/icn\^es  on  the  skin.  At  the 
same  time  the  possibility  cannot  be  ignored  that  the  electric 
waves  sent  forth  by  the  apparatus  may  have  some  conceivable 
effect  on  other  organs.  This  latter  effect  might  then  be 
applied  for  medical  purposes,  as  d'Arsonval  intended.  Could  the 
existence  of  such  an  action  be  definitely  proved,  the  method  of 
d'arsonvalisation  might  fairly  be  ranked  amongst  other  radio- 
therapeutic  procedures. 

§  25.  The  Therapeutical  Application  of  High-Frequency 

Currents. 

Soon  after  the  publication  of  d'Jrso}ivars  researches,  his 
method  became  exploited  by  many  writers  as  the  best  for  all 
sorts  of  diseases,  both  internal  and  external.  Of  late,  however, 
there  has  been  a  marked  change  of  opinion,  and  the  earlier 
enthusiasm  has  given  way  to  scepticism.  The  reason  for  this  is 
probably  to  be  found  in  the  fact  that  in  many  cases  repetitions 
of  d'Jrsoniuil's  experiments  gave  negative  results.  Clinically, 
too,  results  fell  far  short  of  what  had  been  expected;  conse- 
quently in  some  quarters  the  whole  method  received  unqualified 
condemnation. 

This  attitude  is  by  no  means  justifiable,  nor  is  it  fair  to  stig- 
matise all  d' Arsonval's  deductions  as  incorrect.  The  author 
is  bound  to  confess  that  he  obtained  no  more  success  than  many 
others  who  experimented  on  "auto-conduction";  nevertheless  he 
is  of  opinion  that  his  failures  were  probably  due  to  certain  de- 
tails lacking  in  his  technique,  and  more  especially  to  deficiencies 
in  the  currents  he  employed.  The  statements  of  the  man  to 
whom  we  owe  so  many  important  discoveries  are  not  to  be  dis- 
regarded in  so  off-hand  a  manner.  It  would,  howe\'er,  be  very 
desirable   if  d'Arsonz'al  would  give  us  minuter  details  of  the 


')   Elektrotechnischc  Zcit.,  1899,  No.  4. 
'.^   Quoted  l)y  -V.  JclUnck. 


1 66  RADIO-THERAPY 

arrangement  of  his  experiments  so  that  they  could  be  repeated 
under  exactly  the  same  conditions. 

As  regards  the  utility  of  these  currents  in  medicine,  there  can 
be  no  doubt  that  they  are  successful  in  dealing  with  certain 
affections  where  other  methods  have  failed.  Apart  from  their 
value  in  asthenic  conditions  of  the  nervous  system,  their  bene- 
ficial effects  in  certam  local  and  superficial  affections  Is  beyond 
dispute.  These  good  ejects  are  quite  on  a  level  with  those  pro- 
duced by  faradic  and  static  apparatus. 

Indications. 

D'Arsonval  Infers  from  his  bacteriological  experiments  that 
d'arsonvalisation  produces  a  direct  stimulant  effect  on  the  vital 
processes  In  the  cell-protoplasm  while  exerting  no  Influence 
whatever  on  the  nervous  system.  Previous  methods  of  electrifi- 
cation acted  directly  on  the  nervous  system  and  only  Indirectly 
on  metabolism  by  the  medium  of  sensory,  vaso-motor,  and  nutri- 
tion-nerves. Apostoli  says  d'arsonvalisation  "is  a  medicament 
for  the  cell  and  a  powerful  modifier  of  the  general  nutrition, 
which  It  can  at  once  promote  and  regulate." 

D'Arsonval  and  his  pupils,  M.  Benedict  and  others,  acting 
on  the  results  of  their  physiological  experiments,  laid  down  the 
following  Indications  for  the  employment  of  high-frequency 
currents : 

1.  The  production  of  analgesia  In  minor  operations  and  the 
relief  of  superficial  neuralgia. 

2.  Those  diseases  which  are  due  to  defective  tissue-change 
{Bouchard)  :  Diabetes,  mellitus,  gout,  rheumatism,  obesity. 

3.  Parasitic  diseases  (tuberculosis). 

4.  Diseases  of  the  nervous  system. 

5.  Various  local  diseases  of  the  skin  and  mucous  membrane. 

/.    Analgesia. 

The  high-frequency  method  can  scarcely  be  recommended 
for  anaesthetic  purposes  in  the  case  of  surgical  operations. 
Indeed,  Its  analgesic  effect  would  appear  to  be  but  trifling  at  the 
best.     What    there    Is    may  be    accounted  for    partly    by    the 


HIGH-FREQUENCY  CURRENTS  167 

mechanical  concussion-effect  on  the  tissues  partly  by  the  local 
anaemia  caused  by  the  discharges,  by  which  the  sensory  nerve- 
endings  suffer  in  nutrition.  Baedeker^)  states  that  in  his  case 
d'arsonvalisation  caused  impaired  sensitiveness  lasting  for  five 
minutes;  this  was  succeeded  by  hypera^sthesia  and  increased  sen- 
sibility for  temperature.  Cruet  and  Oudiu,'-)  Reqiiier  and  Dids- 
biiry  ■')  recommend  the  process  as  an  anaesthetic  for  dental 
surgery.  They  stipulate  that  the  current  be  of  150  to  300  ma. 
intensity.  Dr.  Bum  has  recently  experimented  in  the  author's 
establishment  with  Oudin's  effluvium  for  tooth  extraction. 
Sometimes  the  patients  said  that  they  felt  less  pain,  but  results 
were  often  negative;  it  is,  however,  interesting  to  note  Bum's 
observations  that  bleeding  was  diminished. 


2.   Diseases  Associated  With  Defective  Metabolism. 

D'Arsonval  reported  to  the  Academic  des  Sciences  (July 
6th,  1896)  that  he  had  been  successful  with  two  cases  of  dia- 
betes and  one  of  obesity.  The  patients  stood  in  a  foot-bath  in 
which  one  pole  was  immersed,  the  other — a  forked  electrode — 
was  held  in  the  hand. 

In  the  first  case  of  diabetes  the  daily  amount  of  urine 
fell  in  42  days  from  11  litres  to  7;  the  sugar  from  620 
grm.  to  180  grm. ;  arterial  pressure,  the  pulse-rate,  and 
the  temperature  were  raised.  The  body-weight  at  first 
rapidly  decreased,  but  soon  advanced  again.  Treat- 
ment: daily  sittings  of  10  minutes. 

In  the  second  case  also  there  was  a  diminution  in  the 
sugar-secretion;  here,  however,  the  treatment  was  not 
so  well  borne,  but  left  a  feeling  of  lassitude. 

In  the  third  case  (a  fat  cabman,  weighing  130 
kgrm.  and  having  irregular  action  of  the  heart)  daily 
sittings  of  10  minutes  were  given;  later,  as  the  patient 
complained  of  dyspncta,  the  sittings  were  reduced  to  3 


')    Loc.   cit. 

^)   Soc.  franc,  d'elcctrotlierapic.  1898. 

')   Lc  progres  med.,  Vol.  XIV.  No.  13. 


i68  RADIO-THERAPY 

minutes.      In   this   case   an   Increase  was   noted   in   the 
amount  of  urea  secreted. 

Apostoli  ^)  asserts  that  he  has  obtained  splendid  results  by 
means  of  general  d'arsonvalisation  in  cases  of  this  class.  He 
treated  518  patients,  giving  altogether  12,728  sittings  and 
noted  invariably: 

Gradual  Improvement  in  the  general  health,  increase  of 
energy,  return  of  the  appetite,  better  sleep.  Improved  digestion, 
an  improvement  In  the  patient's  temper,  better  working  and 
walking  capacity.  Arthritis  and  chronic  rheumatism  Improved 
rapidly  after  the  "auto-conduction"  in  from  4  to  30  sittings; 
movement  became  easier  and  painless. 

According  to  Apostoli,  high-frequency  currents  are  injurious 
in  acute  rheumatism,  not  very  efficacious  In  subacute  rheuma- 
tism, but  excellent  for  chronic  rheumatism;  they  are  good,  more- 
over, for  obesity  and  asthma  (which  is  said  often  to  accompany 
arthritis),  anaemia,  chlorasmia,  and  diabetes.  He  states  that  in 
the  case  of  the  latter  sugar  is  "often  diminished";  in  many  cases 
where  the  sugar  was  not  lessened  in  amount,  the  general  health 
was  nevertheless  Improved.  Similar  opinions  are  offered  by  Th. 
Giiilloz.  Moiitief-)  states  that  he  has  cured  two  patients  with 
urinary  calculus  In  25  sittings  held  2-3  times  a  week  (auto-con- 
ductions followed  by  "static  baths"  and  gentle  discharge-cur- 
rents of  20-30  minutes).  After  the  first  few  sittings  stones  are 
said  to  have  been  voided  in  masses  (a  doubtful  testimony  In 
favor  of  high-frequency  currents).  Moutier  also  reports  the 
cure  of  two  cases  of  biliary  calculus. 

Laqiierriere  ^)  speaks  well  of  the  method  In  the  treatment  of 
diseases  associated  with  defective  tissue-change. 

On  the  other  hand,  T.  Cohn  and  Loezvy,  also  Doumer^) 
state  that  they  have  observed  no  improvement  In  the  case  of 
diabetes.  Baedeker  treated  three  diabetics  In  the  large  solenoid. 
The  sugar  was  not  altered  in  amount  thereby,  but  some  trouble- 
some symptoms  (pruritus,  dryness  In  the  throat)  were  relieved. 


')   Compt.    rend,    du    XII    Congr.    intcrnat.    de   medicine,    Vol.    II,    Sect. 
4a,  p.  69. 

")  Annales  d'electrobiologie,  Vol.  II,  p.  47. 
")   Ibid.  Vol.  III. 


HIGH-FREQUENCY  CURRENTS  169 

Kindler')  also  only  obtained  negative  results  with  these 
affections. 

Th.  Giiilloz'-)  reports  that  a  case  of  obesity  which  had 
much  improved  under  the  direct  continuous  current  again  put  on 
flesh  when  high-frequency  currents  were  applied  by  auto-con- 
duction. 

Moiitier'')  remarks  that  d'arsonvalisation  effects  no  real 
loss  of  weight  in  obesity,  but  a  general  decrease  in  corporeal 
bulk,  the  tissues  increase  in  density. 

Foveau*)  found  d'arsonv^alisation  ineffective  in  obesity  but 
states  that  thyroid  treatment  is  better  borne  in  conjunction  with 
it.  Doiimer  ■')  stated  at  the  Congress  for  Radiology,  1900,  that 
there  existed  unanimity  of  opinion  as  to  the  ineffectiveness  of 
d'arsonvalisation  in  diseases  associated  with  defective  tissue- 
change.  The  author's  own  experience  in  this  direction  has  not 
been  very  extensive.  He  has  treated  some  cases,  which  would 
be  classified  among  the  "arthritis"  group  by  the  French  school, 
by  means  of  auto-conduction,  but  has  seen  no  v^ery  definite  re- 
sults. Now  and  then  it  is  true  that  patients  declared  them- 
selves feeling  better,  but  these  w^erc  generally  neurotic  indi- 
viduals who  were  probably  under  the  influence  of  suggestion. 
Nevertheless  he  thinks  it  quite  possible  that  d'arsonvalisation, 
as  well  as  any  other  form  of  high-tension  electricity,  may  exert 
a  favorable  influence  on  this  kind  of  disease.  Beneficial  effects 
in  the  case  of  internal  disease  might  reasonably  be  looked  for, 
bearing  in  mind  the  counter-irritation  produced  by  the  currents 
on  the  skin.  Where  the  skin  surface  treated  is  fairly  large,  one 
might  assume  that  by  making  it  hyperiemic  the  blood-supply  of 
internal  organs  would  be  somewhat  modified.  ^Ihc  local  irrita- 
tion of  the  skin  plays  a  considerable  part  in  the  often  successful 
treatment  of  these  diseases  by  water  or  light.  This  local  irrita- 
tion is,  of  course,  quite  insignificant  in  the  treatment  by  auto- 


')  Annales  d'elcctrnliiolngic.  Vol.  III. 

^)  Congr.  de  Radiologic,   Paris,   1900. 

')  Acad.  d.  Sc,  May  i,  1899. 

*)  Fortschr.  d.  Medicin,   1901,  No.   13. 

")  I    Congr.  d.  Radiologic,  Paris,  Compt.  rend. 


I70  RADIO-THERAPY 

conduction,   but  more  marked  when  the  currents  are  applied 
locally. 

Oiidin  states  that  by  means  of  the  local  application  of  high- 
frequency  currents  he  obtained  results  quite  similar  to  those  pro- 
duced by  d'Arsonval's  auto-conduction  method.  He  claims  that 
by  local  applications  along  the  spinal  column  he  obtained  an  in- 
crease in  blood-pressure,  improvement  in  arthritis  and  old  pleu- 
ritic eftusions,  and  in  pulmonary  tuberculosis. 

J.    Tuberculosis. 

In  the  year  1899  the  newspapers  published  a  sensational  re- 
port that  Tesla  had  succeeded  in  curing  pulmonary  tuberculosis 
by  high-frequency  currents. 

The  report  was  not  confirmed.  Tesla  had  evidently  only 
suggested  the  possibility  of  this  cure,  arguing  from  the  bacterici- 
dal effects  of  his  currents,  and  this  possibility  is,  of  course,  not 
precluded.  But  the  history  of  medicine  teaches  that  the  thera- 
peutical efficacy  of  a  method  may  be  quite  independent  of  its 
physiological  value;  w^hat  succeeds  in  the  laboratory  often  fails 
entirely  in  clinical  practice.  Consequently  we  must  not  take  it  as 
a  matter  of  course  that  a  method  which  proves  efficacious  in 
dealing  with  pure  cultures  of  pathogenic  micro-organisms  will 
be  equally  successful  in  dealing  with  the  disease  itself. 

In  the  second  part  of  the  Annales  d'electrobiologie,  etc. 
(1900),  E.  Doumer  mentions  a  series  of  17  cases  of  advanced 
tuberculosis  which  he  had  treated  4  years  previously  with  high- 
frequency  currents.  He  exposed  those  parts  of  the  chest-wall 
corresponding  to  the  lung  trouble,  the  supra-clavicular  region, 
and  the  supra-  and  infra-spinal  regions  to  the  effluvium  from  an 
Oudin's  resonator.  In  another  series  of  cases  he  used  the  efflu- 
vium from  the  secondary  coil  of  Tesla  s  transformer.  The  sit- 
tings took  place  daily  as  a  rule  for  5-12  minutes.  He  did  not 
try  to  avoid  direct  spark-shocks,  but  on  the  contrary  endeavored 
to  produce  them. 

The  first  effects  (after  5-8  sittings)  included  easier  breathing 
and  disappearance  of  the  evening  rise  of  temperature.  After  2 
months  the  patient  began  to  put  on  flesh,  while  the  cough  and 


HIGH-FREQUENCY  CURRENTS  171 

expectoration  diminished.  The  stethoscopical  signs  persisted 
longer.  During  the  course  of  treatment,  baciUi  in  the  sputum 
gradually  decreased  in  numbers,  sometimes  disappearing  alto- 
gether for  a  time,  to  return  later.  Since  improvement  in  the 
general  health  always  precedes  diminution  in  the  number  of 
bacilli,  Doiimer  is  inclined  to  ascribe  the  beneficial  effects  of 
high-frequency  currents  in  this  disease  to  their  power  of  so  im- 
proving the  general  nutrition  that  the  patient's  resisting  powers 
against  the  micro-organisms  are  likewise  strengthened. 

Ondin  also  reports  similar  improvements  in  pulmonary  tu- 
berculosis.^) He  used  the  strongest  possible  discharges  from  his 
resonator.  He  applied  the  current  to  the  thorax  for  10  or  15 
minutes,  laying  his  Hngers  on  an  adjacent  part  of  the  chest  wall 
"so  as  to  direct  the  currents  as  far  as  possible  to  the  diseased 
portion  of  the  lung."  Towards  the  end  of  each  sitting  he 
stroked  the  skin  with  a  brush,  thereby  causing  it  to  be  bom- 
barded with  numerous  sparks.  Gaiidil'-)  states  that  he  ob- 
tained rapid  cures  with  Oiidin's  resonator  even  in  advanced 
stages  of  the  disease  and  under  bad  hygienic  conditions.  Ri- 
viere  reports  similar  results.  R.  Siiduik'')  states  that  he  cured 
a  tubercular  abscess  of  the  bone  and  several  glandular  abscesses 
by  means  of  high-frequency  currents.  (His  account  of  the  case 
of  bone-abscesses  is,  however,  by  no  means  convincing;  it  might 
hav'e  healed  spontaneously  in  much  the  same  way  he  describes.) 

The  above  reports  are  no  doubt  very  interesting,  and  deserve 
careful  analysis.  The  author,  in  conjunction  with  Dr.  Kahane, 
has  undertaken  a  series  of  like  investigations,  and  results  will  be 
published  in  due  course.  He  thinks  it  better  to  wait  until 
lengthy  and  careful  observation  of  many  cases,  with  detailed 
examination  of  all  the  physical  symptoms  from  time  to  time, 
entitle  one  to  form  conclusions. 

It  may  here  be  mentioned  that  pulmonary  tuberculosis  is 
said  to  have  been  cured  also  by  other  varieties  of  electrical  dis- 


')  Annales  d'elcctrobiologie,  Vol.  II.  p.  382. 

-)  Compt.  rend,  des  seances  du  I  Congr.  internal.  dTilcclrologie,  pp.  697, 

755. 

■')  Ibid,  page  312. 


172  RADIO-THERAPY 

charges,   e.  g.,  those  from  static  apparatus    {Wassilief^) ^  Ni- 
kolsky'-) . 

4.   Afeclions  of  the  Nervous  System. 

Influenced,  no  doubt,  by  their  teacher  d' Arsonval,  who  says 
that  high-frequency  currents  have  no  effect  on  the  peripheral 
nerves,  either  sensory  or  motor,  ApostoU,  Berlioz  and  others, 
deny  their  beneficial  action  in  any  case  of  nervous  disease.  Apos- 
toli,  indeed,  says  that  they  only  aggravate  cases  of  neurasthenia, 
hysteria  and  neuritis;  he  regards  these  diseases,  which  are  in- 
fluenced so  favourably  by  static  electricity,  as  contra-indications 
for  the  employment  of  high-frequency  currents. 

In  the  author's  opinion  one  cannot  distinguish  between  the 
physiological  effects  of  a  static  apparatus  and  those  of  an 
Oitdiii's  resonator.  Both  kinds  of  apparatus  are,  as  stated  above, 
producers  of  spark-discharges,  and  if  one  acts  beneficially  in 
certain  cases,  the  other  should  also  be  of  value.  The 
author  has  repeatedly  found  that  certain  nervous  affections  for 
which  franklinisation  is  recommended  as  the  remicdy  "par  ex- 
cellence" have  improved  under  uni-polar  discharges  from  induc- 
tion apparatus,  or  discharges  from  Oiidin's  resonator;  on  the 
other  hand,  there  are  unfortunately  very  many  cases  where 
neither  franklinsation  nor  high-frequency  currents  are  the  least 
use.  Nevertheless,  ApostoU's  statement  would  appear  to  be  far 
too  sweeping  and  by  no  means  proved.  The  author,  indeed, 
holds  that  in  certain  nervous  diseases  good  effects  are  sooner 
obtained  (by  means  of  high-frequency  currents)  than  in  other 
diseases  of  the  general  organism.  We  must,  however,  carefully 
distinguish  the  effects  of  auto-conduction  from  those  of  direct 
local  application. 

Auto-conduction  would  appear  to  have  a  strong  "sug- 
gestive" effect  upon  the  patient.  He  is  likely  to  be  impressed, 
and  his  imagination  stimulated,  by  the  sight  of  the  apparatus 
with  its  accompanying  phenomena;  it  seems  to  him  that  such  a 
powerful  treatment  must  necessarily  be  successful. 


')   Klin.-thcrap.  Wochenschr.,  1898,  No.  22. 
'O  Wratsch,  igoo,  No.  15. 


HIGH-FREQUENCY  CURRENTS  173 

The  whole  procedure  may  be  regarded  as  a  "suggestive" 
remedy,  therefore,  which  is  justifiable  only  in  severe  cases,  and 
especially  those  of  the  depressed  type.  Cases  of  functional  im- 
potence, for  example,  have  done  remarkably  well  under  this 
method  after  other  methods  {e.  g.,  hydrotheraphy)  which  were 
known  to  the  patient  had  failed.  On  the  other  hand,  cases 
associated  with  nervous  excitement  mostly  do  badly,  their  rest- 
lessness, insomnia,  etc.,  being  aggra\atcd  by  the  treatment. 

The  effect  of  a  resonator-discharge  is  of  a  different  and  more 
material  order.  The  results  are  often  surprisingly  good,  and 
may  be  explained  by  the  counter-irritant  effect  upon  the  skin  and 
the  direct  action  upon  the  nerves  themselves.  Sciatica,  the 
shooting  pains  of  Tabes  dorsalis,  neuritis,  neuralgia,  and  ar- 
thritic pains  have  been  relieved  in  this  way. 

A  patient,  aged  30,  who  had  been  incessantly 
tortured  by  neuralgic  pains  along  the  right  sciatic  and 
anterior  crural  nerves,  so  that  w^alklng  and  standing 
were  difficult  and  his  sleep  much  disturbed,  was 
vastly  improved  by  this  method.  The  painful  regions 
were  lightly  stroked  daily  for  10  minutes  with  an  uncov- 
ered electrode.  The  first  few  sittings  relieved  the  patient, 
and  after  7  sittings  he  was  permanently  cured. 

A  female  patient  wms  recently  under  treatment,  in 
the  author's  institute,  for  aural  neuralgia  with  insomnia. 
This  case  Dr.  Kahaue  speedily  cured  by  local  application 
of  high-frequency  currents. 
Baedeker  ^)  speaks  well  of  the  effect  of  auto-conduction  on 
the  insomnia  of  ner\'ous  and  hysterical  patients.     His  opinion 
is  corroborated  by  7\  CoJin  '-)  and  Boissciut  dc  Rochcr  '') .     Bae- 
daeker  also  obtained  good  results  in  local  d'arsonvalisation  for 
neuralgia  (sciatica,  cervical,  intercostal  and  occipital  neuralgia). 
He  found  that  neuralgia  of  the  fifth  nerve  was  aggravated  by 
the  resonator-discharge;  myalgia,  however,  improved.    Arthral- 
gia and  erythromelagia  arc  said  to  have  impro\-ed  after  a  few 
sittings.     Headache  of  ncr\ous,  ana-mic,  or  unemic  origin  was 


')   Wiem-r   Klinik.  Vol.  XXVII,   Nos.   lo  and   ii. 
")    Rcrlin.  klin.  Wodi..   njoo. 
^)  Compt.  rend.,  p.  351. 


1 74  RADIO-THERAPY 

cured  by  d'arsonvalisation.  E.  Kindler^)  found  it  improved 
the  general  debility,  paraesthesia,  hyperaesthesia  and  insomnia  of 
neurasthenia;  Apostoli  obtained  success  with  migraine,  arthritic 
neuralgia,  lithiasis,  varix,  haemorrhoids,  constipation  and  dys- 
pepsia. 

In  cases  where  the  spark-discharge  from  a  resonator  has 
been  indicated,  the  author  has  applied  this  daily,  from  6  to  20 
minutes  in  the  first  stages,  afterwards  every  second  or  third  day 
only.  The  spark-application  should  be  continued  until  the  skin 
shows  distinct  signs  of  reaction ;  the  time  of  the  appearance  of 
this,  of  course,  depends  upon  the  intensity  of  the  discharge. 

5.     Affections  of  the  Skin  and  Mucous  Membranes. 

It  can  hardly  be  questioned  that  definite  results  are  obtained 
by  discharges  from  an  Oiidin's  resonator  upon  certain  super- 
ficial diseases.  These  results  may  be  ascribed  to  the  local  effects 
of  the  spark-shocks,  and  also  to  the  more  quiet  discharges, 
whereby  mechanical,  chemical,  or  thermal  effects  ensue.  Pos- 
sibly in  some  cases,  e.  ^.,  pruritus,  ciynamic  electricity  may  play 
a  lesser  part;  in  the  main,  however,  the  mechanical  effect  of  the 
sparking  must  be  considered  as  the  chief  factor.  Proof  of  this 
may  be  found  in  the  fact  that  when  the  electrode  is  kept  tightly 
pressed  against  the  skin  no  alteration  takes  place  in  the  lesion; 
results  are  only  obtained  when  the  electrode  is  kept  at  some  little 
distance  away,  so  that  sparks  bombard  the  skin.  In  the  first 
case,  dynamic  electricity  alone  is  operating,  while  in  the  second 
we  have  the  addition  of  static  discharges. 

Already  this  method  of  applying  high-frequency  currents 
has  found  a  large  field  in  dermatology.  Oudin,  Bollaan  and 
others  have  used  it  successfully  for  molluscum  contagiosum, 
psoriasis,  eczema,  pruritus,  impetigo,  herpes  zoster,  furunculo- 
sis,  acne,  acne  rosacea,  seborrhcea,  sycosis,  tuberculosis  of  the 
skin  and  venereal  warts;  Oudin  and  Barthelemy  for  keloid;  Bis- 
serie,  Bordier,  Gaston,  Chahry  and  Rieder  for  alopecia  areata; 
Pearsons  and  Riviere  for  epithelioma ;  Bisserie  for  lupus  ery- 
thematosus, and  Brocq  for  atrophia  cutis,  etc. 


')   Fortschr.  4-  Medigin,  1901,  No.  13, 


HIGH-FREQUENCY  CURRENTS  175 

Thus  we  may  see  that  many  writers  claim  to  have  achieved 
good  results  upon  ulcers  and  parasitic  affections  of  the  skin  by 
this  method,  which  combines  high-tension  electricity  with  spark- 
discharges.  Lupoid,  trophic,  \  aricose  and  venereal  ulcers,  impe- 
tigo, acne,  furunculosis,  gonorrhoea,  and  alopecia  areata  (which 
most  of  these  authors  regard  as  a  parasitic  disease)  are  said  to 
have  been  cured  in  this  way. 

We  may  therefore  regard  parasitic  skin  diseases  as  suitable 
for  this  particular  mode  of  employing  high-tension  electricity. 
The  author's  own  experience  is  as  follows :  By  the  use  of  spark- 
discharges,  however  produced  (whether  from  high-frequency 
apparatus  of  static  machines,  etc.),  he  has  obtained  a  distinctly 
good  effect  upon  ulcers.  The  earliest  sign  has  been  a  drying 
and  cleansing  of  the  ulcer  base.  With  lupus  ulcerations  he  ob- 
serv^ed  after  a  few  days  a  tendency  towards  healing,  even  in 
obstinate  cases.  But,  while  acknowledging  this  improvement, 
he  feels  bound  to  state  that  up  to  the  present  he  has  not  suc- 
ceeded in  absolutely  curing  an  ulcer  of  infective  origin  by  this 
process.  Together  with  Schijf ,  he  treated  a  soft  chancre  in  this 
way,  with  the  view  of  testing  the  parasiticidal  action  of  spark- 
discharges.  The  same  effects  were  observed  as  with  lupus  ulcer- 
ations— a  cleansing  and  drying  of  the  ulcer-base.  Nevertheless 
the  ulcer  showed  no  tendency  to  heal  quicker  than  usual,  and 
after  6  sittings  the  treatment  was  abandoned  in  favour  of  the 
iodoform  method.  The  impression  gained  was  that  at  the  best 
the  high-frequency  method  in  this  case  was  no  improvement  on 
older  methods.  Brocq^)^  Bisserie~)  and  Gaston  obtained  a 
temporary  and  slight  improvement  with  lupus  vulgaris;  even 
this,  however,  was  not  lasting  ■'). 

Probably  the  morbid  infiltration  in  these  cases  is  too  deep- 
seated  for  the  spark-discharge,  which  loses  its  effect  at  the  sur- 
face. 7  he  author's  microscopical  investigations  lend  support 
to  this  theory. 


')  Traitement  des  dermatoses,  Paris,  1898. 

')  Journ.  des  malad.  cutan.,  1898.  p.  372. 

')  Chisholm  Williams  (meeting  of  British  Medical  Association,  Man- 
chester, 1902)  reports  that  he  cured  a  case  of  facial  lupus  by  general 
d'arsonvalisation.     This   experience   appears   to   be   unique. 


176  RADIO-THERAPY 

JVith  a  suitable  arrangement  of  the  apparatus  {sufficiently 
powerful  currents,  etc.)  the  discharges  may  be  made  to  pene- 
trate 'very  deeply  {see  the  experiments  quoted  on  p.  lOg  and 
I2g;  according  to  Flemmings  reports  (quoted  by  Strebel), 
alternating  currents  of  lesser  frequency,  e.  g.,  lOO  per  second, 
penetrate  about  26  mm.  into  copper,  while  those  of  1,000,000 
per  second  penetrate  only  jV  mm.  Those  of  slower  rate  can 
poietrate  various  media,  including  human  skin,  and  exert  vig- 
orous bactericidal  ejects  of  some  depth.  It  has,  however,  not 
proved  possible  as  yet  to  use  the  apparatus  necessary  for  this 
penetration  in  practice. 

The  author's  experience  of  high-frequency  currents  in  the 
treatment  of  alopecia  areata  is  not  quite  in  accordance  with  that 
of  other  writers.  Many  of  them  claim  to  have  cured  this  dis- 
ease by  faradic  and  static  electricity  and  by  d'Arsonval's  high- 
frequency  currents.  The  writer  treated  a  boy  suffering  from 
alopecia  areata  by  uni-polar  discharges  on  a  bald  plaque.  After 
some  time  lanugo  appeared,  but  on  the  whole  the  result  was 
quite  inconclusive.  Scliiij  afterwards  treated  the  same  patient 
by  Ehrmann's  method  of  faradisation,  but  without  success. 
Since  that  time  the  author  has  often  repeated  the  experiment, 
but  with  no  better  results.  Assuming  that  the  treatment  has 
been  successful  in  some  cases  of  alopecia  areata — and  the  bona 
fides  of  other  workers  is  not  to  be  questioned — the  question 
arises,  is  the  gooci  effect  due  to  the  destruction  of  micro-organ- 
isms, or  to  the  counter-irritations  and  consequent  increased 
blood-supply  to  the  definitely-acting  hair  papilla??  Before  leav- 
ing the  subject  of  the  treatment  of  alopecia  areata  by  high-fre- 
quency currents,  we  may  refer  to  an  observation  by  Neumann, 
who  aptly  states  that  decided  proof  of  the  efficacy  of  the  method 
can  only  be  looked  for  in  a  universal  alopecia  of  several  years' 
standing,  in  which  the  possibility  of  spontaneous  healing  is  prac- 
tically excluded.  It  would  appear  desirable  that  experiments 
should  continue  in  this  field.  Processes  which  are  undoubtedly 
infective  in  origin  (such  as  trachoma)  should  be  subjected  to 
this  treatment. 

A  second  group  of  skin-diseases  which  are  benefited  by 
high-tension  electricity  is  to  be  found  in  those  disorders  which 


HIGH-FREQUENCY  CURRENTS  177 

are  characterised  by  hypertrophy  of  the  fibrous  tissues  and 
chronic  cell-infiltration  of  the  cutis.  From  many  reliable  sources 
come  reports  of  success  with  keloid,  cicatrices,  sclerema  circum- 
scriptum, and  elephantiasis  by  these  means.  Bisserie,  whose 
authority  is  beyond  question,  gives  an  account  In  a  notable 
work  ')  of  the  treatment  of  62  cases  of  lupus  erythematosus,  33 
of  which  were  completely  and  permanently  cured  by  high-fre- 
quency currents.  Jaquot,  too,  cured  39  cases  out  of  56  with  this 
disease. 

These  results  are  probably  to  be  explained  by  the  electrolytic 
effect  on  the  tissues  by  the  high-tension  electricity;  again  we  must 
count  as  favourable  factors  the  heat-effects,  the  mechanical 
effects  ("electrical  massage"),  the  mechanical  destruction  of  im- 
portant parts  of  the  diseased  tissue,  and  the  decreased  nutrition 
of  the  morbid  growth  which  results  from  alterations  In  Its  vas- 
cular supply. 

The  author  himself  had  a  case  of  lupus  erythemato- 
sus of  the  face  under  treatment,  in  which  his  experience 
agreed  on  the  whole  with  that  of  Bisserie.     A  dark-red 
erythema  first  appeared,  not  only  In  the  lesion  Itself,  but 
forming  a  border  \y  cm.  In  breadth  around  it.    The  scales 
and  crusts  gradually  left  the  diseased  site.     Then  the 
erythema  began  to  diminish,  finally  disappearing  alto- 
gether.   Some  pigmentation  was  left  behind.    The  treat- 
ment could  not  be  continued,  unfortunately,  as  the  pa- 
tient failed  to  attend. 
We  may  note  the  fact  that  Roentgen-treatment  with  hard 
tubes.  In  which  high-tension  electricity  probably  plays  an  impor- 
tant part,  succeeds  also  with  this  class  of  disease  (elephantiasis, 
lupus  erythematosus). 

The  third  Important  indication  for  the  application  of  high- 
tension  electricity  is  to  be  found  in  pruritus  and  prurlginous  af- 
fections generally. 

The  author,  in  company  with  others  (Brocf/,  Bisserie,  Ler- 
edde,  and  even  Strauss,  who  believes  this  to  be  the  only  legiti- 
mate use  of  high-frequency  currents)  has  obscrvetl  a  favourable 


')  Journ.   dc   Medicine  ct  dc   Chinirgic   pr;.ti(|ucs,    February  25,    lyoi. 


178  RADIO-THERAPY 

effect  in  most  cases  of  essential  and  symptomatic  pruritus  [e.  g., 
in  jaundice  and  eczema)  by  means  of  high-frequency  currents, 
faradic  electricity,  and  uni-polar  discharges  from  a  Riihinkorff's 
coil.  The  distressing  itching  is  markedly  relieved,  sometimes  in 
a  comparatively  short  time  (after  5  sittings).  The  author  has 
.not  been  able  to  histologically  examine  a  portion  of  the  treated 
skin  and  so  determine  the  cause  of  this  success,  but  clinical  obser- 
vation and  theoretical  reasoning  would  support  the  idea  that  the 
production  of  heat  and  the  mechanical  impact  of  the  sparks  are 
of  importance.  Possibly,  too,  the  stimulation  of  the  local  circu- 
lation, the  counter-irritant  effects  of  the  spark-discharge  and  its 
mechanical  or  electro-chemical  influence  on  the  peripheric  nerve- 
terminations  are  to  be  considered.  The  relief  of  the  pruritus  of 
impetigo,  eczema,  etc.,  may  be  explained  by  the  destruction  of 
the  denuded  nerve-endings.  But  the  whole  question  requires 
further  and  more  exact  mvestigation  for  its  elucidation. 

Polar  discharges  from  high-tension  induced  currents  em- 
ployed in  this  way  have  a  distinct  depilatory  effect.  This  was 
confirmed  by  Schif  ^)  by  experiment  on  his  own  cuticle,  and 
also  by  Kaiser-).  Disturbances  of  the  circulation  in  the  skin 
are  successfully  treated  by  the  discharges  from  an  Oudin's  reso- 
nator. We  have  already  seen  that  the  effluvium  causes  some  local 
anaemia  from  vascular  spasms;  this  property  may  be  utilised  in 
the  treatment  of  paretic  conditions  of  the  skin  capillaries.  Thus 
the  high-frequency  currents  may  be  used  with  advantage  in  the 
treatment  of  chilblain  and  certain  other  angioneuroses.  The 
author,  in  company  with  TJiielee,  Baudet,  and  others,  has  seen 
very  good  results  with  perniones,  especially  as  regards  the  relief 
of  itching.  It  must  be  noted  that  the  same  success  can  be  ob- 
tained by  using  electrical  discharges  which  are  otherwise  pro- 
duced; for  instance,  faradic  currents  have  the  same  effect.  This 
was  first  proved  by  Gaiitier.  We  have  already  mentioned  (p. 
160)  the  use  of  spark-discharges  in  producing  desquamation  of 
the  epidermis  (for  cases  of  acne,  seborrhea,  ephelides,  chloas- 
ma). The  author  has  seen  definite  though  not  very  extraordi- 
nary results  achieved  in  this  way. 

')  K.  k.  Gesellschaft  der  Aerzte  Wien,  Dec.  14,  1900. 
^)  Wiener  klin.  Woch.,  1901,  No.  31. 


HIGH-FREQUENCY  CURRENTS  179 

Some  writers  speak  well  of  the  use  of  high-frequeiicv  cur- 
rents in  affections  of  the  nuicous  membranes.  'I'hus  E. 
Doitmcr,^)  R.  SiuJiiik-)  and  Su-nibu,)  mention  good  effects 
in  cases  of  hcTmorrhoids,  which  they  describe  as  antiphlogistic 
and  "resolving."  The  former  effect — the  antiphlogistic — is 
said  to  relieve  the  congestive  symptoms  after  a  few  sittings, 
while  the  "resolving"  appears  later,  but  Is  seen  in  e\-en  old  and 
in\eterate  cases.  Doumcr,  moreover,  mentions  extremely  good 
results  with  lissura  ani,  which  he  states  is  cured  in  from  2  to  6 
sittings  of  y6  minutes  each. 

Tschddno'zc  ^)  made  extensive  trials  of  the  method  in  85 
cases  of  fissura  ani  with  very  good  results.  He  used  bi-polar 
discharges,  without  resonator,  curing  his  cases  after  1^3^  sit- 
tings applied  e\ery  other  day.  The  pain  was  first  relieved,  then 
the  straining,  later  the  sphincter-spasm,  the  difficult  defiecation, 
and  the  bleeding.     1  he  fissures  healed  perfectly  in  every  case. 

R.  Siidiiik'')  reports  that  he  has  used  high-frequency  cur- 
rents successfully  in  conjunctivitis  granulosa  and  in  blenorrhcca 
urethras  with  paraphimosis.  He  treated  gonorrhcra  by  w'rapping 
the  penis  in  cotton-wool  covered  by  a  zinc-plate,  to  which  the 
currents  were  conducted.  Or  the  penis  was  placed  in  a  glass 
tube  with  a  metallic  bottom,  and  containing  boracic  lotion ;  the 
metallic  bottom  was  then  conducted  with  one  end  of  the  sole- 
noid, the  other  end  being  joined  to  an  electrode  placed  over  the 
perineum.  He  treated  the  urethro-vaginitis  of  women  by  intro- 
ducing a  moist  plug  of  cotton-wool  into  the  vagina  and  connect- 
ing it  with  one  end  of  the  solenoid,  the  other  end  being  connected 
with  an  electrode  applied  to  the  hypogastrium.  By  this  pro- 
ceeding the  micro-organisms  are  saitl  to  be  killed;  nevertheless, 
the  discharge  is  not  completely  remo\ed.  Application  of  the 
currents  to  the  perineum  is  said  to  suppress  inflammation  of  the 
back  part  of  the  urethra  In  recent  cases.  From  other  experiments 
Sudnik  Infers,  moreover,  that  the  antiphlogistic  action  of  high- 


')  Ann.  d'clcctroljiologic,  etc..  1898. 

■)  Ibid.   1899. 

^)  Dcutsch.   nicd.   Woclu-n-clir..    1902,   No.  8. 

*)  Botkin's  Hospitalzeitung.    igoo.  No.  30. 

°)  Ann.  d'elcctrobiologic,  Vol.  II.  p.  31^. 


i8o 


RADIO-THERAPY 


frequency  currents  is  useful  in  boils,  buboes,  orchitis,  and  acute 
articular  rheumatism.  Doiimer^)  confirmed  Sndnik's  opinion. 
He  found  that  in  gonorrhoea  the  inflammation  was  rapidly  sup- 
pressed, while  the  discharge  and  pains  soon  disappeared. 

The   reader   is   referred  to   an   earlier   description    for  the 
technic]ue  of  the  method  of  local  application  (see  Fig.  60).    It 


Fig.  60. 

is  sometimes  advisable  to  apply  the  currents  daily;  at  others 
twice  or  thrice  a  week  will  suffice.  The  sittings  may  vary  in  time 
from  2  to  10  minutes.  The  operator  must  be  guided  always  by 
the  reaction  seen  on  the  skin.  As  a  rule,  several  weeks  are  re- 
quired for  a  cure,  if  this  be  attainable.  Bisserie  gives  70  sittings 
as  the  utmost  required  for  the  treatment  of  lupus  erythematosus. 
For  other  diseases,  however,  such  as  pruritus  and  eczema,  even 
from  3  to  5  sittings  may  suffice. 

Summary. 


In  the  d' Arsonval-Oiidin  method  of  treatment  we  have 
clearly  one  which  utilises  both  electrical  waves  and  static  dis- 
charges.    We  have  seen  that  while  the  high-frequency  currents 


')   Congr.  intern,  d'electrobiologie,  August  i,   1900. 


HIGH-FREQUENCY  CURRENTS  i8i 

produced  by  the  present-day  apparatus  give  us  physiological 
and  therapeutic  results  which  are  somewhat  indefinite,  the  re- 
sults obtained  from  the  static  discharges  of  Oiufiii's  resonator 
may  be  more  exactly  demonstrated. 

We  have  thus  to  deal  mainly  with  effects  which  are  quite 
similar  to  those  produced  by  faradisation  and  franklinisation. 
The  only  difference  is  one  of  degree,  corresponding  to  the  dif- 
ference in  current  intensity  of  the  several  apparatus. 

From  a  survey  of  the  physiological  and  clinical  effects  of 
high-tension  electricity  (including  the  discharges  from  induc- 
tion-, influence-, and  d' Arsonval-Oiidin' s  apparatus)  we  may  say: 
That  this  method  possesses  many  advantages  in  common  with 
Roentgen-therapy;  thus  it  dispenses  with  dressings  and  causes 
little  pain,  the  sittings  last  but  a  few  minutes  each,  so  that  no 
great  sacrifice  is  demanded  from  the  patient,  and  finally  that  the 
cosmetic  results  are  very  good. 

We  have  seen  that  the  method  possesses  certain  valuable 
properties  (bactericidal,  desiccating,  anti-pruritic)  which  are  oi 
advantage  in  several  skin-diseases;  we  have  found,  however, 
that  its  virtues  are  not  so  pronounced  that  older  and  more  ap- 
proved methods  may  be  disregarded.  Nevertheless,  due  atten- 
tion must  be  paid  to  a  new  department  which  has  undoubtedly 
enriched  our  therapeutical  resources,  trusting  that  in  time  it 
may  receive  the  improvement  and  scientific  development  which 
it  now  so  greatly  lacks.    • 

The  treatment  by  monopolnr  voltmc  currents  should 
probably  he  included  in  radio-therapy.  Narkieivicz- 
Jodko  and  Colombo  utilise  the  cathodal  waves  from  a 
Ruhmkorffs  coil  for  curative  purposes.  The  operator 
holds  in  his  hand  a  test-tube  containing  liquid  in  which 
the  anodal  terminal  (a  copper  plate)  is  immersed.  The 
operator  then  strokes  the  patient  with  the  other  hand. 
The  patient  thereby  receives  electrical  waves  from  the 
cathode,  and  becomes  charged  with  negative  electricity. 
It  is  said  that  by  this  method  the  same  results  are 
achieved  as  by  d'/Irsonval's  auto-conduction  process'). 


')    Biillctino  (Ulla   R.  Accad.  di  Roma,   iSqO- 


1 82  RADIO-THERAPY 

Appendix. 

§  25.  In  the  treatment  of  the  so-called  ''''permeating  electric- 
ity" method  oi  E.  K.  Mueller  (Zurich)  the  patient  is  exposed  to 
the  influence  of  a  magnetic  field  of  high  intensity  produced  by  a 
powerful  wave-forming  current. 

The  apparatus  consists  in  the  main  of  a  wire  spiral  of  over 
200  windings  traversed  by  a  current  of  high  intensity  (20-60 
amperes)  but  low  tension  and  frequency.  By  these  means  a 
magnetic  field  of  low  frequency,  but  high  intensity,  is  produced; 
the  lines  of  force  in  this  magnetic  field  penetrate  the  body  which 
is  to  be  treated. 

The  wire  spiral  surrounds  a  core  composed  of  layers  of  para- 
magnetic material  (soft  iron,  nickel,  etc.),  and  containing  a  cen- 
tral space  for  system  of  cold-water  circulation.  The  coil  itself, 
moreover,  is  provided  with  a  cooling  arrangement. 

The  coil  may  be  supplied  with  a  continuous  or  an  alternating 
current.  The  current  merely  needs  to  vary  periodically  in  in- 
tensity, its  direction  being  immaterial.  This  undulating  supply- 
current,  whether  continuous  or  alternating,  will  always  produce 
alternating  currents  in  the  windings  of  the  coil  by  self-induction, 
and  these  in  turn  will  create  an  undulatory  magnetic  field.  The 
para-magnetic  core  is  not  absolutely  essential,  but  it  enhances  the 
magnetic  effect. 

According  to  Rodari,^)  the  treatment  has  the  reverse  of  the 
stimulating  action  on  the  organism  produced  by  d' Arsonval's 
method.     The  effect  is  said  to  be  mainly  on  the  nervous  system. 

Rodari  gives  the  following  indications  for  its  employment: 

1.  Peripheric  nerve  diseases  (neuroses)  :  neuralgia  of  the  trigemi- 
nal, occipital  and  temporal  nerves;  diffuse  headache;  migrain; 
neuralgia  of  the  brachial  plexus,  of  the  intercostal  nerves;  sciat- 
ica; conditions  of  a  neuralgic  nature,  especially  writers'  cramp, 
cramp  in  the  calf;    also    lumbago    and    muscular    rheumatism. 

2.  Central  neurosis:  irritative  forms  of  acquired  neurasthenia 
with  insomnia.  3.  Sensory  disorders  of  internal  organs:  angina 
pectoris,  hypera^sthesia  of  the  gastro-intestinal  tract.     4.    Local 


')   Berlin,  klin.  Woch.,   1901,  Nos.  23  and  24. 


HIGH-FREQUENCY  CURRENTS  183 

acute  gout.  5.  Ataxia  and  the  shooting  pains  of  tabes  dorsalis. 
Since  the  publication  of  these  indications  another  has  been 
adcied  to  the  list,  viz.:  6.  Subacute  articular  rheumatism. 

S.  Kuznitzky')  reports  the  cure  by  this  method  of  an  obsti- 
nate lumbago,  which  disappeared  after  5  sittings  of  20  minutes 
each.  A  valuable  St.  Bernard  dog  suffering  from  palsy  of  the 
hindlegs  is  said  to  have  been  cured  in  3  sittings.  P.  Ishewsky'-) 
states  that  his  investigations  show  that  an  electro-magnetic 
field  produced  by  alternating  currents  of  high-frequency  and 
high  tension  causes  considerable  changes  in  the  organism  and  in 
the  skin.  He  noted  especially  increase  of  blood-pressure,  the 
pulse  becoming  slower  and  fuller,  and  the  respiration  less 
frequent  and  deeper,  while  the  sensibility  of  the  skin  for  percep- 
tion of  space  and  faradic  irritation  became  heightened.  More- 
over, he  found  a  striking  increase  of  general  liveliness  on  the 
part  of  the  patient,  and  rapid  recovery  from  the  effects  of  hard 
mental  work.  We  may  conclude  from  this  that  an  undulating 
magnetic  field  does  not  act  soothingly  in  Rodari's  sense,  but 
rather  as  a  stimulant,  like  d' Arsonval's  alternating  currents. 
Here,  too,  the  disturbing  effects  on  the  electrical  equilibrium  act 
as  physiological  irritants  (see  p.  164). 

That  magnetism  is  under  certain  circumstances  capable  of 
exciting  similar  physical  phenomena  to  those  produced  by  the 
other  kinds  of  "radiation"  treated  of  in  this  work  may  be  proved 
by  Ph.  Braham's^)  experiment.  In  this  a  sensitised  photo- 
graphic plate  is  placed  between  the  poles  of  a  powerful  electro- 
magnet having  an  interrupted  current;  a  similar  impression  is 
made  on  the  plate  as  by  ordinary  light,  a  black  portion  appear- 
ing on  development  corresponding  to  the  part  situated  directly 
between  the  poles. 

Grenee'^)  has  made  similar  observations;  Ch.  Graf;')  on 
the  other  hand,  was  unable  to  confirm  these  experiments. 


')  Aerztlichc   Rmulscliau,   Munich,    1901.   No.   50. 

')  Nachr.  d.  kais.  Militaer.  mcd.  Akad..   Petersburg,   1901.  No.  3. 

')  Phot.  News,  1889,  p.  620. 

*)  Ibid.   1889,  p.  751. 

")  Phot.  Chronik.,  1899,  p.  82. 


1 84  RADIO-THERAPY 

The  following  experiments  are  more  reliable : 

D'Arsonval  (Compt.  rend.  Acad.  d.  sc,  Vol.  126,  p.  919) 
states  that  the  eye  is  affected  as  by  light  when  it  is  brought  into 
an  electro-magnetic  field.  Dr.  Beer  has  recently  confirmed 
this  observation.  Even  in  the  year  1857  the  well-known  dis- 
coverer of  the  "Od,"  Baron  Reichenbach,  declared  that  "sen- 
sitive" subjects  have  a  sensation  of  bluish  phosphorescence  under 
the  influence  of  the  north  pole  of  a  powerful  electro-magnet, 
combined  with  the  sensation  of  a  refreshing  breath  of  wind; 
under  the  influence  of  the  south  pole  there  is  the  sensation  of  yel- 
lowish phosphorescence  and  of  a  tepid  enervating  current  of  air. 

According  to  Hermmin's^)  researches,  animal  substances 
are  diamagnetic. 

Pluecker ")  found  that  when  blood  was  brought  into  a  mag- 
netic field,  there  was  a  repellent  effect  amongst  the  corpuscles. 
Milk  showed  the  same  phenomena  with  its  fat  globules. 

Ch.  Fere'^)  tried  to  prove  by  experiment  that  a  magnet  is 
capable  of  increasing  muscular  power;  at  first  the  power  is  said 
to  diminish,  then  to  increase.     North  and  south  poles  act  alike. 

Many  other  physiological  effects  have  been  ascribed  to  mag- 
netism ;  the  statements  are  mostly,  however,  from  unreliable 
sources,  and  will  not  bear  investigation. 


')  PAucgcr's  Arch.,  Vol.  XLIII,  pp.  217,  218. 
')  Pogg.  Ann.,  1848,  Vol.  LXXIII,  p.  549. 
^)-  See.  d.  biologic,  1902. 


III. 

TREATMENT    WITH    X-RAYS. 


TREATMENT  WITH  X-RAYS. 

The  X-Ray  Method'). 
§  26,  Cathode  and   Roentgen-Rays. 

We  have  already  seen  that  air  offers  great  resistance  to  the 
passage  of  electricity,  which  can  only  be  overcome  by  very  high 
tensions. 

If  one  discharges  an  electric  machine  or  a  Riihinkorff' s  coil 
through  a  medium  of  rarefied  gas,  one  obtains  a  greater  spark- 
length  with  the  same  potential  -) . 

By  lessening  the  density  of  the  air,  therefore,  the  resistance 
opposed  to  the  passage  of  electricity  is  also  lessened. 

The  pressure  of  a  gas,  as  is  well  known,  is  measured 
by  the  height  in  millimetres  of  a  column  of  mercury 
which  it  counterbalances.  Normal  atmospheric  pressure 
— called  "atmosphere" — is  the  pressure  equivalent  to 


')  Literature:  E.  P.  Thompson  and  W.  A.  Anthony,  Roentgen-rays  and 
phenomena  of  the  Anode  and  Cathode.  New  York,  1896. —  Fortschritte  auf  dem 
Gebiete  der  Roentgenstrahlen,  Hamburg,  Jahrg.  I-V.  —  /.  M.  Eder,  Jahr- 
biicher  fiir  Photographic,  etc.  Jahrg.  X-XVI,  Halle  bei  Knapp. — Piiscy, 
Roentgen-rays  in  the  treatment  of  skin  disease,  etc.  Journal  of  cutaneous 
and  genito-urinary  diseases,  July,  1900.  —  Annales  d'electrobiologie,  Jahrg. 
I,  H,  HI,  IV.  —  Kalischcr,  Streifzuege  durch  das  Gebiet  der  X-Strahlen. 
Elektrotcchnische  Zeitschrift,  1898,  H.  24  fif.  —  Magnus  Mocllcr,  Der  Eintluss 
des  Lichtcs  auf  die  Haut,  Stuttgart.  —  Bucttncr  and  Mueller.  Tcchnik  und 
Verwendung  der  Roentgenstrahlen,  I  and  H,  Aufl.,  Halle  bci  Knapp. — 
L'annee  electrique  der  Fovcau  de  Couniiclles.  iStjo  und  1901.  Paris. — 
Zarahin,  Monatschrift  f.  prakt.  Derniatologie,  15  Mai.  1899.  Text-books: 
Gocht,  II.,  Lehrbuch  der  Roentgenuntcrsuchung.  Stuttgart.  1899.  F.  Enkc.  — 
Bucttncr  und  Mueller,  1.  c.  —  Donath,  B.,  Die  Einrichtungen  zur  Erzeugung 
der  Roentgenstrahlen.  Berlin.  i8gg. — Londe,  A.,  Traite  i)ralifiue  de  Radio- 
graphic et  de  Radioskopie,   Paris,   1898. 

")  Electricity  traverses  a  "Torricellian"  vacuum  with  the  production  of 
light-i)henomcna. 


1 88  RADIO-THERAPY 

760  mm.  of  mercury.  In  a  vessel  whose  atmospheric  con- 
tents have  been  reduced  by  means  of  a  pump  to  i  mm. 
pressure,  there  remains  but  liu  part  of  the  original  quan- 
tity of  air. 
In  order  to  utilize  highly-rarefied  gases  and  vapours   for 
these  purposes,  Gassiot,  Pluecker,  and  Geissler  sealed  them  in 
tubes  and  globes  of  glass.    The  glass  vessels  were  first  provided 
with  platinum  or  aluminium  wires  arranged  in  suitable  places  as 
electrodes,  and  these  latter  connected  with  the  secondary  termi- 
nals of  a  Ruhmkorfj   coil.     The  electrode  conveying  positive 
electricity  is  known  as  the  anode;  that  which  conveys  negative 
electricity  is  the  cathode.     The  electrodes  are  not  invariably 
simple  wires;  they  are  fashioned  according  to  requirement  in 
the  form  of  plates  or  rings. 

A  high-tension  current  can  easily  traverse  a  tube  exhausted 
to  an  atmospheric  pressure  of  3  mm.,  causing  its  contained  gas 
to  glow^).  Entirely  different  light-phenomena,  however,  are 
seen  at  the  electrodes;  the  negative  terminal  is  covered  by  a  thin 
light  layer,  then  follows  a  darker  space — the  dark  cathode-space 
— which  is  again  succeeded  by  a  light  band — the  light  cathode- 
band.  From  this  glowing  light  rays  extend  with  diminishing 
brightness  towards  the  anode.  Then  follows  a  dark  space, 
behind  which  the  positive  light  begins.  This  consists  of  a 
great  number  of  alternately  dark  and  light  bands. 

The  electric  glow-light  in  vacuum  tubes  is  now  gen- 
erally looked  upon  as  a  kind  of  fluorescence — or  phos- 
phorescence— phenomenon  of  the  gas,  which  glows  under 
the  influence  of  the  negative  electrical  particles,  the 
cathode-rays  which  are  thrown  off  by  the  cathode.  H. 
Ebert~)  shewed  that  the  properties  causing  the  visible 
phenomena  of  light  continue  after  cessation  of  the  light, 
yet  remain  so  effective  that  they  considerably  influence 
the  succeeding  discharge  and  its  characteristic  appear- 


^)  ]Vicdcinann  proved  ( Wiedemann's  Ann.,  V,  p.  500,  1878;  VI,  p.  278, 
1879)  that  the  gas  begins  to  glow  at  a  temperature  below  100°.  We  must, 
therefore,  assume  that  the  electric  discharges  act  directly  on  the  "ether." 
(See  also  the  Electron-theory.) 

")   Wiedemann's  Annalcn,  1899,  d.  LXIX,  p.  372. 


TREATMENT  JJITH  X-RAYS  189 

ances.     These  after-effects  appear  mainly  to  be  due  to 
the  continuance  of  certain  charges,   which,   (.luring  the 
process  of  discharge,  are  communicated  to  the  gas.     It 
is  principally  in  the  zone  of  gas  around  the  cathode  that 
these  after-effects  are  manifested. 
If  the  current  is  passed  for  a  long  time  in  the  same  direc- 
tion through  the  glass  vessel,  the  wall  of  the  latter,  which  faces 
the  negative  electrode,  becomes  covered  with  a  metallic  deposit 
from  the  electrode. 

If  the  air  be  gradually  exhausted  from  a  Geisslcrs  tube,  the 
light  first  begins  to  disappear  from  the  cathode,  where  soon  a 
luminous  point  only  remains,  then  from  the  anode,  anci  tinally 
altogether.  On  the  other  hand,  the  vessel  wall  begins  to 
fluoresce,  between  _^^^o  and  t,jVu  mm.  pressure,  the  light 
being  green  or  blue,  according  to  the  nature  of  the  glass. 
This  fluorescence  is  caused  by  a  certain  kind  of  rays  proceeciing 
from  the  cathode.  They  were  discovered  by  JV.  Hittorf  in 
1869  ^).  These  rays,  whose  study  was  continued  with  such  suc- 
cess by  Goldstein,  Hertz,  Lenard,  Crookcs,  roller,  JJ'iedemann 
and  others,  proceed  from  the  cathode.  Goldstein  called  them 
cathode-rays,  Crookes  "radiati)i<(  matter."  llieir  cathodal 
origin  may  be  assumed  from  the  fact  that  only  that  part  of  the 
tube-wall  fluoresces  which  is  directly  opposite  to  the  cathode. 
They  have  not  the  pozier  of  penelratini^  .s/<^/-^'-S  l^'il  ^'f'^'  trans- 
formed into  heat.  In  other  words,  they  become  completely  ab- 
sorbed as  soon  as  they  strike  the  wall  of  the  tube.  These 
cathode-rays  proceed  in  a  perpendicular  direction  from  the  sur- 
face of  the  cathode,  quite  independently  of  rhe  anode's  position. 
If,  therefore,  the  cathode  be  shaped  as  a  concave  mirror,  the 
rays  become  focussed  in  some  spot,  and  here  the  temperature 
may  reach  such  a  height  that  anv  body  encountered  at  this  focus 
begins  to  glow.  Again,  the  tube-wall  may  be  so  softened  by  the 
heat  as  to  become  broken  through  by  the  external  atmospheric 
pressure.  Substances  which  fluoresce  well  in  ordinary  light  show 
the  phenomenon  in  a  still  higher  degree  under  the  influence  of 
cathode-rays.      The    effect   of    rays   proceeding   simultaneously 


*)  i^f^tig-  Ann.,  CXXXV'I.  pp.  i,  07. 


I90  RADIO-THERAPY 

from  several  cathodes  is  very  remarkable.  They  mutually  di- 
vert each  other,  as  can  be  seen  from  the  fluorescence  on  the  tube- 
walls.  Crookcs  introduced  a  metal  cross  in  the  path  of  the  rays. 
He  found  this  arrested  all  the  rays  striking  it,  giving  a  shadow 
of  the  cross  on  the  wall  of  the  tube,  and  thus  incidentally  fur- 
nishing proof  positive  that  these  rays  proceed  in  straight  lines. 
A  powerful  magnet  has  also  the  property  of  deflecting  cathode- 
rays,  as  can  be  easily  demonstrated  by  first  bringing  a  shadow- 
casting  body  in  their  path.  E.  Jriedcnicuui  and  Ebert  observed 
that  this  deflection  is  fan-shaped  ^).  The  shadow  always  takes 
another  position  and  shape  '),  according  to  the  position  of  the 
magnet.  Cathode-rays  seem  also  to  possess  a  motive  power.  If 
they  impinge  on  a  lightly-hung  fly-wheel,  the  latter  begins  to 
move.  Not  only  the  glass  of  the  tube,  but  also  nearly  every 
(non-metallic)  body  with  which  they  come  into  contact  is  made 
to  fluoresce  by  cathode-rays.  The  colour  of  this  fluorescence  de- 
pends upon  the  nature  of  the  body.  Moreover,  these  rays  have 
an  active  effect  upon  photographic  plates.  Becquerel  and  Gold- 
stein found  also  that  the  rays  have  the  power  of  imparting  vivid 
colour  to  certain  colourless  salts.  This  property  E.  Wiede- 
mann and  G.  B.  Sclmiidt  believe  to  be  due  to  a  reducing  action. 
Goldstein  found  that  not  only  "alkalihaloid"  salts,  but  also  sul- 
phates, phosphates,  and  carbonates  were  coloured  if  first  power- 
fully heated. 

Radium-rays,  ultra-violet  light,   and  Roentgen-rays 

(Holzkneclit)  are  capable  of  producing  the  same  colour 

effects. 


^)    Sitzungsber.  der  pliys.-med.   Soc.  zu  Erlangen,  December,   1890. 

°)  It  is  interesting  to  note  that  Prof.  Goldstein,  of  Berlin,  described  two 
Icinds  of  cathode-rays  in  1866 — those  which  can  be  deflected  by  a  magnet 
and  those  which  cannot.  The  latter,  as  we  shall  see,  are  the  Roentgen-rays. 
Lcnard  (Vortrag  v.  d.  Gesellsch.  Dentsch.  Naturforschr.,  Frankfurt,  1897) 
found  that  this  penetrating  power  of  cathode-rays  decreases  the  more  they 
are  diverted  by  a  magnet.  He  could  not  deflect  the  external  cathode-rays 
(Lcnard-rays)  magnetically.  Lcnard  also  demonstrated  the  fluorescence 
within  the  tube  caused  by  the  rays,  their  power  of  penetrating  opaque  bodies, 
their  increase  of  the  electric  conducting-power  of  air  or  gases  which  they 
traverse,  and  their  photographic  action  (Goldstein).  The  greater  the  electric 
force  employed  in  the  production  of  these  rays,  the  less  are  they  capable 
of  being  deflected  from  their  course. 


TREATMENT  WITH  X-RAYS  191 

Most  bodies,  especially  metals,  are  opaque  to  cathode-rays. 
Aluminium,  however,  as  Hertz  has  shown,  is  an  exception. 
Lt'fiard^)  made  tubes  of  this  metal  so  that  the  cathode-rays 
could  penetrate  the  tube-wall,  and  thereby  be  more  carefully 
examined. 

The  so-called  channel-rays  radiated  backwards  by  a 
perforated  cathode,  which  were  discovered  by  Goldstein, 
do  not,  according  to  If'ehnelt,  originate  at  the  cathode, 
but  are  merely    positive    ions    which    have    traversed 
the  cathodal  perforations.     Otto  Berg-)    satisfactorily 
proved   that   these   channel-rays   are   in    reality   anode- 
rays. 
In  the  year  1891;  Wilhelm  Konrad  Roentgen  ^)   found  that 
from  the  site  of  the  vacuum-tube  which  is  struck  by  the  cathode- 
rays,  a  new  kind  of  rays  emerges  which  are  not  visible  to  the 
human  eye,  but  which  possess  the  same  properties  which  Lenard 
found  in  his  "external  cathode-rays."    If  one  deflect  the  cathode- 
rays  within  the  tube  by  means  of  a  magnet,  then  the  new  part  of 
the  vessel-wall  struck  by  them  becomes  also  the  site  from  which 
these  new  rays  emanate.  Roentgen  showed  that  these  rays,  which 
he  called  X-rays,  but  which  are  also  known  as  Roentgen-rays  in 
honour  of  their  discoverer,  penetrate  the  glass-tube,  proceed  in 
straight  lines,    and  have   an   actinic  eftect  upon   photographic 
plates.      He  also  showed  their  remarkable  power  of  exciting 
fluorescence   (as,  for  instance,  in  a  screen  coated  with  barium- 
platino-cyanide) . 

The  bulk  of  the  fluorescence  in  a  Roentgen-tube  is 
caused  not  by  the  cathode-rays  themselves,  but  by  the 
X-rays  to  which  they  give  rise.  If  one  brings  a  piece  of 
glass  near  an  active  Roentgen-tube  covered  with  black 
cloth  in  a  dark  room  the  piece  of  glass  begins  to  fluoresce 
{Jf  alter). 
A  fact  of  great  practical  importance  established  by  Eder  and 


')    Wiedemann's  Annalcn.  1894.  51,  225.  and  1897,  63.  25,3. 
')    Wiedemann's  Ann..   1899.  Bd.  I. XVIII.  p.  688. 

*)   Eine  ncuc  Art  von   Stralilcn.    Stabcl'sclie   Hof-   und   Univ.-Bucliliand- 
lung,  Wiirzburg,  1895. 


192  RADIO-THERAPY 

Valenta^)  is  this:  one  can  only  obtain  good  photographic 
results  with  these  rays  by  using  gelatine  plates.  A  collodion- 
plate  is  comparatively  insensitive.  The  effect  of  X-rays,  as  is 
the  case  with  ordinary  light,  decreases  with  the  square  of  the 
distance.  X-rays  penetrate  objects  which  for  ordinary  light- 
rays  are  opaque  with  even  greater  facility  than  cathode-rays") . 
Thus,  for  instance,  a  thick  book,  a  double  set  of  playing  cards, 
thick  blocks  of  wood,  etc.,  are  easily  penetrated  by  X-rays,  as  is 
glass  by  ordinary  light. 

Since,  as  has  been  before  mentioned,  photographic  plates 
proved  sensitive  to  X-rays,  Roentgen  found  that  he  could  take 
photographs  in  a  lighted  room  with  a  plate  hidden  in  a  wooden 
case  or  paper  bag.  Speaking  broadly,  one  may  say  that  the 
lighter  the  specific  gravity  of  a  body,  the  more  transparent  is  it 
to  X-rays.  On  the  other  hand,  a  body's  opacity  for  the  rays 
increases  with  its  density,  though  not  in  the  same  proportion. 
Variations  in  the  density  of  a  given  body  give,  therefore,  varia- 
tions in  its  capacity  for  penetration. 

V.  Novak  and  O.  Sule,'')  also  V  oiler  and  IF  alter, ^)  proved 
that  the  transparency  of  a  body  for  X-rays  depended  less  upon 
its  density  than  its  atomic  weight. 

Eder  and  Valenta  found  that  almost  all  organic  bodies  are 
transparent  to  X-rays  when  they  do  not  contain  any  heavy 
metals,  but  consist  only  of  carbon,  hydrogen,  nitrogen  and 
oxygen. 

From  the  important  transparency-data  published  by  the 
above-mentioned  investigators  it  is  seen  that  magnesium-ribbon 
(tV  and  i  mm.)  is  easily  penetrated,  also  tin-foil;  with  strips  of 
the  latter  of  o.i  to  i  mm.  thickness  they  succeeded  in  making 
graduated  transparency-meters,    recalling  some   of  the   photo- 


')  n.dcr  iind  Valenta,  Versuche  ueber  Photographic  mittels  der  Roent- 
gcnstrahlen.     Wien  und  Halle,   i8g6. 

")  It  must  be  noted  that  other  kinds  of  rays  are  known  which  pene- 
trate opaque  bodies.  For  instance,  a  dark  iodine-bisulphide  of  carbon  solu- 
tion allows  radiant  heat  to  pass  through  it  without  loss.  Again,  electric 
waves,  as  we  have  seen,  penetrate  solid  bodies.  The  penetrating  power  of 
cathode-rays  with  certain  media  has  already  been  mentioned. 

')   Zeitschr.  f.  phys.  Chemie,  1896,   19,  489. 

*)  Zeitschr.  f.  angewandte  Chemie,  1897,  Heft  15. 


TREATMENT  fVlTH  X-RAYS  193 

meters  used  in  photography.  Copper  and  silver  in  layers  of 
0.1  to  0.2  mm.  thickness  are  not  quite  opaque.  On  the  other 
hand,  lead,  platinum,  and  gold  are  highly  opaque,  as  are  also 
zinc  (as  thin  plate),  nickel,  iron,  and  especially  mercury. 

It  is  interesting  to  note  that  rock-crystal  is  not  much  more 
transparent  than  crown-glass,  and  that  flint-glass  stops  X-rays 
even  more  than  crown-glass. 

Glass  with  a  thickness  of  i  mm.  weakens  the  rays  (even  if 
one  uses  the  purest  crown-glass  or  "solinglass"),  and  much  more 
than  an  ahtmiuiiim  plate  of  the  same  thickness.  On  the  other 
hand  an  aluminium  plate  i  cm.  in  thickness  affords  a  very  con- 
siderable resistance.  Hence,  it  follozis  that  in  estimating  the 
transparency  of  a  body  for  X-rays  one  must  take  into  account 
not  only  its  atomic  weight,  but  also  its  thickness.  A  body, 
therefore,  which  in  thin  layers  may  be  comparatively  trans- 
parent to  the  rays,  becomes  in  thicker  layers  quite  opaque.  This 
was  well  shown  in  the  photograph  of  a  cameo  taken  with  X-rays 
by  Eder  and  Valcnta,  the  different  gradations  of  thickness  being 
well  marked.  Layers  i  mm.  thick,  of  bone  or  mother-of-pearl, 
absorb  the  rays  about  as  much  as  glass.  A  layer  of  flesh  i  cm. 
thick  is  as  transparent  as  a  layer  of  bone  i  mm.  in  thickness. 
Horn  is  similar  to  flesh  in  this  respect.  Wood,  even  in  thick 
pieces,  is  very  transparent;  soft  wood  is  more  so  than  hard. 
Caoutchouc,  wax,  strong  leather,  woollen  cloth,  linen,  dressings 
for  wounds,  mica,  and  celluloid  are  all  very  transparent.  Car- 
bon, in  the  form  of  coal,  charcoal,  soot,  black-lead,  or  diamonds, 
is  very  transparent.  Of  phosphorus,  selenium  and  sulphur,  the 
first  has  the  greatest  penetrability,  and  the  last  the  least.  Accord- 
ing to  Marangoni,^)  lithium  is  the  most  transparent  of  all 
metals  for  X-rays.  According  to  Chabaud  -)  and  Schrzvald,  the 
addition  of  halogene  to  the  organic  molecule  greatly  in- 
creases its  opacity  in  this  respect.  This  effect  is  particularly 
well  seen  in  the  case  of  chloroform,  bromoform  and  iodoform. 
Very  dark  shadows  are  cast  by  clear  solutions  of  bromoform, 
also  by  liquid  tetrachloride  of  carbon.    Since  these  combinations 


*)   Atti  R.  Ace.  dei  Lincei   (5)  5.  2.  Sem.,  1896,  page  403, 
*)  C.   ^-    122.   1896,  p.  2^"^, 


194  RADIO-THERAPY 

are  mostly  penetrable  by  ordinary  light-rays,  they  afford,  as 
Sehrwald  observes,  a  very  good  filter  for  X-rays^).  As  re- 
gards liquids,  water  and  bi-sulphide  of  carbon  are  very  trans- 
parent to  the  rays.  Others  again  are  somewhat  more  opaque, 
e.  g.,  blood  and,  as  the  author  has  himself  observed,  solutions 
of  sulphurated  hydrogen. 

If  one  wraps  the  vacuum-tube  in  black  cloth  in  order  to  ex- 
clude all  visible  light-effects,  and  places  near  the  cathodal-ray 
region  a  screen  coated  with  some  fluorescent  body  (the  best  is 
Darium-platino-cyanide) ,  the  latter  at  once  begins  to  shine  with 
a  light-green  radiance  when  the  tube  is  in  a  state  of  activity.  If 
one  then  places  between  the  tube  and  screen  a  body  whose  dens- 
ity varies  in  parts  {e.  g.,  a  boot  with  iron  nails,  a  box  of  weights, 
a  human  hand),  the  dense  portion  will  be  found  to  cast  deeper 
shadows  than  the  more  transparent. 

It  is  to  this  property,  their  power  of  easily  penetrating  softer 
parts,  while  others,  such  as  bones,  are  more  opaque,  and  metals 
(foreign  bodies)  absolutely  so,  even  varying  gradations  of 
shadows  being  corresponding  to  tissues  which  are  air-containing 
or  otherwise,  rich  in  blood  or  the  reverse,  that  the  X-rays  owe 
their  enormous  value  in  medical  diagnosis. 

As  regards  the  chemical  effect  of  X-rays  per  se  opinions  are 
much  divided;  while  many  investigators  (for  instance,  Hemp- 
tinne)  are  inclined  to  deny  the  existence  of  such  an  action,  others 
arguing  from  certain  facts  take  an  opposite  view.  P.  Villard  ^) 
is  to  be  Included  among  the  latter.  He  noted  that  glass  is 
coloured  violet  by  X-rays,  whereas  cathodal  rays  blacken  it. 

Roentgen  thought  it  probable  that  his  rays  are  capable  of 
exerting  a  heat-effect,  since  they  certainly  possess  the  power  of 
producing  light-phenomena  (fluorescence).  He  found  also  that 
they  are  not  refrangible — they  are  not  deflected  by  mica,  rubber 
or  aluminium  prisms  or  lenses.  Moreover,  he  could  not  suc- 
ceed in  finding  any  very  definitely  marked  reflection  of  the  rays; 
on  the  other  hand,  he  found  that  a  photographic  dry-plate  ex- 
posed with  its  glass  side  towards  the  vacuum-tube  and  bearing 


^)   Natnrwissensch.  Rundschau.  II.  1896,  p.  503. 

^)  Poggcndorf's  Bciblatter  zu  den  Annalen  der  Physik,  1900,  p.  135. 


TREATMENT  iriTH  X-RAYS  195 

bright  strips  of  aluminium,  iron,  platinum,  tin  and  zinc,  on  the 
film-side,  gav'e  on  development  darker  patches  corresponding  to 
the  last  three  metals.  The  actinic  effect  was  particularly  marked 
under  the  zinc-strip,  while  the  aluminium  had  absolutely  no 
effect  whatever.  It  would  seem,  therefore,  that  lead,  platinum, 
and  zinc  do  to  some  extent  reflect  the  rays.  Later  on.  Car- 
micliacl  of  Lille  succeeded  in  reflecting  Roentgen-rays  by  means 
of  steel-mirrors.  Roentgen  showed  that  X-rays  are  entirely  dif- 
ferent from  cathode-rays,  and  cannot,  like  the  latter,  be  deflected 
by  a  magnet. 

It  has  been  found  no  more  possible  to  bring  X-rays  to  a 
condition  of  "interference"  than  to  deflect,  refract,  or  polarise 
them.  On  the  other  hand,  they  are  found  to  have  a  discharging 
effect  on  electrified  bodies.  The  leaves  of  a  charged  electro- 
scope rapidly  fall  together  if  the  instrument  be  brought  within 
the  field  of  an  X-ray  tube.  According  to  H.  Starke,^)  this  action 
of  X-rays  is  to  be  compared  with  the  similar  effects  produced  by 
ultra-violet  and  Becquerel-rays.  The  action  of  ultra-violet  light 
is  confined  to  the  cathode;  Roentgen-rays,  however,  have  the 
same  effect  whether  they  strike  the  positive  or  negative  electrode. 
The  effect  on  both  poles  on  the  part  of  X-rays  is  perhaps  only  an 
apparent  one.  According  to  Sagnac,  solid  bodies  which  are 
struck  by  X-rays  emit  new  rays  having  similar  properties.  These 
secondary  rays  likewise  favour  an  electrical  discharge.  It  is 
therefore  possible  that  the  anodal  effect  is  to  be  attributed  to  the 
secondary  rays  emitted  by  the  irradiated  anode  towards  the 
cathode. 

Sella  and  Majorana  ")  found  from  a  scries  of  experiments 
that  the  discharge  depended  largely  upon  the  nature  of  the  irra- 
diated body.  The  discharging  effect  of  X-rays  increases,  ac- 
according  to /. /.  Tliomson,')  Riglii ')  and /^oc;//^^^;/,  with  the 
atmospheric  pressure  on  the  charged  body.  Roentgen  maintains 
that  it  is  the  air  itself  which,  excited  by  the  X-rays,  brings  about 
the  discharge. 


')  Wiedemann's  Ann..   iSoR.  Bd.  LXVI,  p.  lOOQ. 

^)  Atti  dclla  R.  Ace.  dci  Lincci   (5)  5.  I  Sem.,  1896.  p.  116. 

')  Electrician.  39.  7  I'tb.,  1896,  p.  49i- 

*)  Mem.  R.  Ace.  dell'  istituto  Bologna  (5),  5.  i895-i^9f>.  P-  725- 


196  RADIO-THERAPY 

Perrin,^)  Villari'-)  and  JVinkehnaun  ")  believe  that  this  is 
due  to  a  so-called  "ionisation"  of  the  gas,  i.  e.,  the  gaseous 
molecules  are  arranged  in  oppositely-charged  atoms — the 
"ions" — of  which  some  are  repelled  by  the  charged  body,  while 
others  are  attracted,  and  thereby  neutralise  a  portion  of  its 
charge. 

Roentgen-rays,  like  ordinary  light,  increase  the  conducting 
power  of  selenium. 

The  intensity  and  penetrating  capacity  of  X-rays  depend 
very  largely  upon  the  nature  of  the  body  struck  by  the  cathode- 
rays,  or,  in  other  words,  upon  the  nature  of  the  emitting  surface. 
Kaufmann's^)  and  Roitis'')  investigations  seem  to  prove  that 
the  metals  have  a  greater  radiating  power  the  higher  their 
atomic  weight.  Kaiifmanu  lays  down  the  following  series,  in 
which  each  individual  metal  has  a  greater  radiating  capacity 
than  its  predecessor. 

Ag,  Fe  (Ni,  Cu,  Sn,  Zn)  Ag  (Cd,  Pt,  Pb,  U). 

In  the  above  those  metals  included  within  the  brackets  have 
practically  the  same  radiating  capacity. 

If  one  imagines  the  radiating  part  of  the  tube  (the  anti-cath- 
ode— see  below)  to  be  a  luminous  flame  and  the  exposed  body 
a  shadow-casting  object,  one  can  readily  understand  what  will 
be  the  geometrical  configuration  of  the  shadow;  for  since  the 
X-rays  proceed  in  straight  lines,  the  same  laws  of  shadow-forma- 
tion obtain  as  in  optics.  The  picture  seen  on  the  fluorescent 
screen  or  photographic  plate  entirely  bears  out  this  view  *') . 

Every  Imaginable  hypothesis  has  been  brought  forward  to 
explain  the  nature  of  X-rays.  Roentgen's  earlier  view  was  that 
they  were  longitudinal  waves,  progressive  condensations  and 
rarefications  of  the  light-ether.     Other  distinguished  scientists. 


')  C.  R.,  123,  351,  1896,  and  124.  455,  1897. 

*)  Atti  della  R.  Ace.  dei  Lincei  (5),  6,  1897,  343. 

')  Jenaische  Zeitschrift  f.  Naturw.,  Bd.  XXXI,  N.  F.,  1897,   174. 

*)   Verhandl.  d.  phys.  Gesellsch.  zu  Berlin,  30,  4,  1897. 

")  Atti  R.  Ace.  dei  Lincei  (5)  6,  II  Sem.,  pp.  123,  129,  1897. 

*)  In  a  work  published  with  Schiif,  whose  main  contents  are  given  later 
on,  I  have  referred  to  the  circumstances  that  the  geometrical  shape  of  the 
changes  in  the  skin  brought  about  by  X-rays  depends  upon  the  distance  of 
the  skin  from  the  tube. 


TREATMENT  IVITH  X-RAYS  197 

including  Boltzmann,  Lord  Kchin  and  Lodge,  seem  inclined 
to  agree  with  him.  After  referring  to  the  analogy  which  ob- 
tains between  light-ether  and  certain  elastic  (particularly  gelat- 
inous) bodies  as  regards  the  capacity  of  both  for  longitudinal 
and  transverse  vibrations,  Boltzmann  ')  observes:  "In  all  elas- 
tic bodies,  especially  gelatine,  longitudinal  waves  are  trans- 
mitted with  far  greater  rapidity  than  the  transverse  ones.  If 
one  assume  this  also  of  light-ether,  Roentgen-waves,  in  spite  of 
the  very  brief  duration  of  their  vibrations,  may  still  have  fairly 
large  wave-lengths.  1  he  short  vibrating  period  would  explain 
the  phenomenon  of  fluorescence,  which  probably  Is  manifested 
as  soon  as  vibrations  occur  which  are  approximately  as  rapid  as 
those  of  the  molecule.  The  comparatively  large  wave-lengths 
would  explain  the  power  these  waves  have  of  penetrating  most 
bodies.  In  which  respect  they  resemble  Hertzian  waves.  Do 
I  not  observe  every  night  that  from  the  music  in  the  next-door 
house  the  low  deep  notes,  which  have  the  greatest  wave-length, 
penetrate  the  wall  far  more  easily  than  high  notes.  .  .  .  Catho- 
dal rays,  on  the  other  hand,  are  probably  longitudinal,  but  of  very 
short  wave-length ;  in  the  first  respect  they  resemble  Roentgen- 
rays,  In  the  latter  (their  short  w^ave-length  and  therefore  greater 
capacity  for  being  absorbed)  they  are  similar  to  ultra-violet 
light." 

Many  physicists  are  of  the  opinion  that  X-rays  are  ultra- 
violet rays  (that  Is  to  say,  transverse  vibrations  of  very  short 
wave-length),  with  which  they  have  in  common  the  property  of 
extending  In  straight  lines,  of  exciting  fluorescence,  and  most 
likely  of  producing  chemical  action.  They  explain  the  Impossi- 
bility of  breaking  or  polarising  X-rays  by  the  shortness  of  their 
wave-lengths,  and  again  by  the  Imperfections  in  our  apparatus. 

Many  others  again  believe  X-rays  to  be  a  kind  of  cathode- 
rays.  Thus  Roentgen  himself  In  a  later  work-)  thinks  this 
idea  by  no  means  an  impossible  one.  We  have  already  seen  that 
there  are  many  transltipns  from  one  kind  of  ray  to  the  other, 
and  that  they  are  at  all  events  closely  related.     In  his  third 


')  Zeitschr.   fur  Elektrotcchnik,   1896,   15,   i. 
^)   Sitzungsbcr.  d.   Berliner  Akad.,   1897,  26, 


198  RADIO-THERAPY 

treatise  on  the  subject,  Roentgen  is  inclined  to  hold  that  Roent- 
gen-rays and  cathodal-rays  are  phenomena  of  the  same  nature. 

Now  Crookes  has  formulated  the  following  theory  on  the 
nature  of  cathode-rays:  One  must  imagine  that  every  gaseous 
body  is  composed  of  individual  molecules;  these  are  quite  elastic. 
The  so-called  kinetic  theory  of  gases  teaches  that  the  molecules 
of  any  gas  are  charged  with  energy  and  move  with  Infinite  ve- 
locity through  space.  In  doing  this  they  must  impinge  upon  one 
another  eventually.  They  are  then  mutually  repelled  by  reason 
of  their  elasticity,  bounding  apart  like  billiard  balls  which  have 
collided,  thereby  changing  their  direction  and  hurrying  forward 
again  in  straight  lines.  The  more  molecules  there  are  In  an 
enclosed  space,  the  oftener  will  they  bound  against  the  wall 
enclosing  that  space.  The  total  amount  of  these  Impacts  cor- 
responds to  the  pressure  under  which  the  gas  lies.  The  fewer 
molecules  there  are  (i.  e.,  the  lower  the  pressure  of  the  gas), 
the  greater  Is  the  energy  with  which  they  can  travel  on  In 
straight  lines  with  a  correspondingly  larger  course  before  they 
collide  with  other  molecules,  and  so  become  diverted.  Crookes 
concludes  that  the  very  low  pressure  In  his  tubes  makes  It  possi- 
ble for  the  few  remaining  gas-molecules  to  travel  with  enormous 
force  and  thereby  develop  the  remarkable  properties  seen  In 
cathodal-rays.  He  holds,  therefore,  that  these  rays  are  con- 
stituted by  the  gas  molecules,  and  that  they  are  minute  particles 
of  gas  (proceeding  from  the  cathode)  to  which  a  tremendous 
motive  power  has  been  imparted  by  the  electric  current.  The 
comparatively  small  number  of  these  particles  prevent  their 
being  hindered  In  their  career  by  one  another;  they  thus  come 
into  violent  contact  with  any  body  which  lies  in  their  path,  caus- 
ing It  to  become  heated  by  the  molecular  bombardment  and  so 
perhaps  to  glow  or  melt. 

Gintl  and  Puhij  held  a  theory  that  cathode-rays  were  due  to 
material  particles  of  the  cathode  hurled  forward  In  straight 
lines,  heat  being  developed  as  the  result  of  their  impact  against 
the  tube-wall. 

Crookes'  gas-molecule  theory,  as  described  above,  would 
seem  to  explain  fairly  well  most  of  the  phenomena  observed 
in    connection    with    cathodal-rays,    such    as    their    deflection 


TREATMENT  fJlTll  X-RAYS  199 

in  a  magnetic  field,  their  heat-eftects,  and  supposed  mechanical 
effects. 

Closer  investigation,  however,  proved  that  Crookes'  hypoth- 
esis was  untenable.  Quite  recentlv  this  question  has  again 
come  to  the  fore  in  connection  with  a  theory  first  propounded  by 
Hertz,  then  by  Perrin,')  J.  J.  Thomson'-)  and  IV.  JFkii,'-') 
that  cathode-rays  carry  a  negati\e  electric  charge  with  them, 
which  is  essential  to  their  very  nature — that  they  are  themselves 
negative  electricity  in  motion.  The  researches  of  E.  Jl'iech- 
ert*)  JF.  Kaufmann;')  E.  Aschkinass,'')  Ph.  Lcnard,')  Th.  dcs 
Coudres  *')  all  showed  that  Crookes'  theory  required  modifica- 
tion only  in  order  to  satisfactorily  explain  practically  all  the 
phenomena.  The  cathode-rays  should,  according  to  these  phys- 
icists, be  regarded  as  charged  particles,  but  the  ordinary  mate- 
rial particles  of  gas  must  not  be  held  to  constitute  the  carriers  of 
the  charge.  These  are  to  be  looked  for  in  much  smaller  ele- 
ments, the  "ions,"  "component  parts  of  the  ether"  (Leriard)  or 
"electrones"  (Stoney),  which  are  considerably  less  in  size  than 
ordinary  material  atoms.  By  examining  a  whole  series  of  the 
properties  of  cathode-rays  it  became  possible  to  determine  the 
amount  of  the  charge  in  the  case  of  these  particles.  These  data 
corresponded  very  closely  with  those  which  Zeeman  had  already 
obtained  for  the  particles  associated  with  the  optical  phenom- 
enon which  bears  his  name.  Hence,  IViechert's  '')  hypothesis, 
that  in  both  cases  one  is  dealing  with  the  same  particles,  /.  <'., 
electrones,  would  appear  reasonable.  JViechcrt  estimates  the 
velocity  of  an  electron  in  its  flight  to  be  \—l  that  of  light. 
In  consequence  of  this  enormous  velocity  the  impact  of  an  elec- 


')  C.  R.,  1895,  121,  p.  1 130. 

'')   Phil.  Mag.   (5)  44.  i«97.  P-  293. 

')   Verhandlungen  der  phys.  Gesellsch.,  Berlin,  Nov.   19.  1897,  16,  165. 

*)  Sitzungsber.  der  phys.-okon.,  Ge.sellsch.,  Konigsberg,  1897,  p.  i.  Na- 
turw.  Rund.,  May,  1897. 

')  Wicdmann's  Ann.,  61,  344  (1897);  62,  596  (1897);  65,  431  (1898); 
66,  649  (1898). 

')   Wiedemann's  Ann.,  62,  588  (1897). 

')    Wiedemann's  Ann.,  64.  279  (1898)  ;  65.  504  (1898). 

')   Vehr.  d.  phys.  Ges..  Berlin,   17,   17   (1898). 

")  Gocttingcr  gel.  Nachrichtcn,  1898,  p.   i,  260. 


200  RADIO-THERAPY 

tron  against  a  solid  body  sends  an  explosion-like  electric  wave 
into  space,  just  as  a  projectile  at  the  moment  of  impact  emits  a 
sound-wave.  Wiechert  thinks  it  not  unlikely  that  Roentgen-rays 
may  be  electro-dynamic  wave-movements,  manifested  as  a  series 
of  short,  rapidly-succeeding  waves.  The  real  carrier  of  these 
wave-movements  is  the  all-parading  ether, 

Walter^)  Batelli  and  Garbaso,')  Michelson,^)  Muraoka*). 
Vosmaer,  Ortt^")  and  other  scientists  regard  Roentgen-rays 
as  cathode-rays  which  have  given  oft  their  charge  at  the 
tube-wall  or  at  the  anti-cathode  from  whence  they  spring, 
thereby  gaining  in  power  of  penetration.  They  are  therefore 
cathode-rays  sifted,  as  it  were,  by  the  media  through  which  they 
pass.  Assuming  that  Roentgen-rays  are  themselves  non-electri- 
cal, we  can  the  more  readily  understand  that  on  the  one  hand 
they  tend  to  discharge  an  electrified  body,  and  on  the  other  hand, 
like  all  non-electric  or  non-magnetic  bodies,  they  are  not  de- 
flected by  a  magnet.  JVehnelt's  ^)  observation  again,  that  the 
production  of  X-rays  depends  on  no  factor  so  much  as  the 
presence  of  rapidly-suppressed  discharges,  that  is  to  say,  a  dis- 
turbance of  electrical  equilibrium  giving  rise  to  powerful  electric 
waves,  induces  B.  Donath  ')  to  assume  that  there  is  some  con- 
nection between  Roentgen-rays  and  electrical  waves,  and  that 
the  former  are  electrical  waves  of  the  most  diminutive  wave- 
length. 

It  is  very  likely  that,  just  as  white  light  is  composed  of 
various  colours,  Roentgen-rays  may  also  be  of  various  kinds, 
which  differ  from  each  other  in  their  penetrative  power  as  well 
as  in  their  physical  and  physiological  effects.  We  shall  examine 
this  question  more  closely  when  speaking  of  vacuum-tubes. 


^)   Fortschr.  a.  d.  G.  d.  Roentgenstr.,  Bd.  II,  H.  4. 
^)   Nuov.  Cim.   (4)  3,  1896,  p.  299. 
^)  American  Journal  of  Science  (4)   i,  1896,  p.  314. 
0   IViedcmann's  Ann.,  59,  1896,  p.  yy^i- 
°)   Nature,  56,  1897,  p.  316. 
")    IViedcfuann's  Ann..  65,  511.  1898. 

)   B.  Donath,  Die  Einrichtungen  zur  Erzeugung  der  Roentgenstrahlen, 
Berlin,   1899. 


TREATMENT  fl'lTH  X-RAYS  201 

§  27.  Vacuum   Tubes. 

A  vacuum-tube  is  an  apparatus  in  which  electrical  energy 
is  transformed  into  Roentgen-rays.  The  quality  of  the  rays  de- 
pends upon:  I,  the  kind  of  electrical  energy  employed;  2,  the 
condition  of  the  tube. 

I'he  intensity  of  the  rays  increases  with  the  quantity  of 
electrical  energy  consumed.  Consequently  not  only  higiier  ten- 
sion, but  also  greater  current-intensity,  causes  a  more  powerful 
emission  of  X-rays. 

The  condition  of  the  tube  is  always  a  factor  of  prime  im- 
portance for  the  production  of  an  abundant,  strong,  and  con- 
stant supply  of  X-rays.  It  was  the  caprices  of  tubes  and  their 
slight  resisting  capacity  which  accounted  for  so  many  failures 
in  the  earlier  history  of  X-ray  work. 

The  earlier  forms  of  Crookes'  tubes  were  pear-shaped  or 
cylindrical.  The  cathode  was  button-shaped,  or  later  on  con- 
sisted of  an  aluminium  disc  or  concave  mirror  (Fig  61).  A 
pin  or  ring  of  aluminium  was  first  used  for  the  anode;  later  on 
the  latter  was  shaped  in  the  form  of  a  plate  fitting  in  a  side- 
chamber  of  the  tube. 

Now  in  these  earlier  forms  of 
tube  the  most  eftective  rays  pro- 
ceeded from  a  comparatively 
large  and  curved  surface.  Con- 
sequently they  were  lacking  in 
power,  and  gave  only  ill-defined 
shadows  of  an  object.  The  portion  (From  A.  Londc,  Traite  pra- 
Of     the     glass     bombarded     by     the         tique  dc  Radiographic.     Paris, 

cathode-rays  agam  was  very  liable 

to  become  over-heated,  whereby  it  softened  and  gave  way  under 
the  external  atmospheric  pressure.  Fortunately  the  production  of 
X-rays  is  not  solely  dependent  upon  the  impact  of  cathodal-rays 
on  glass — on  the  contrary,  other  materials  arc  just  as  suitable,  or 
even  more  so.  Roentgen  soon  found  that  his  rays  could  be 
emitted  from  a  platinum  surface,  and  here  he  was  dealing  with 
a  material  which  withstood  high  degrees  of  heat  and  was  there- 
fore all  the  more  suitable.     In  order  that  clear  shadow-pictures 


202  RADIO-THERAPY 

may  be  given,  the  source  of  the  rays  must  be  In  the  form  of  a 
point,  or  at  least  very  small,  and  this  requirement  was  met  by 
employing  an  aluminium  concave  mirror  as  cathode. 

On  these  principles  Roentgen,  Jackson  and  others  con- 
structed the  so-called  focus-tubes;  these  marked  an  era  in  X-ray 
work.  Focus-tubes  are  so  arranged  that  the  rays  produced  in 
them  proceed  from  one  point  only,  whereby  considerably  greater 
intensity  is  attained.  For  this  purpose,  as  mentioned  above,  an 
aluminium  concave  mirror  is  used  as  cathode.  A  small  platinum 
plate — the  anti-cathode — is  now  fixed  between  the  disc-shaped 
anode  and  the  cathode,  opposite  the  centre  of  the  latter.  This 
anti-cathode  is  so  placed  that  it  coincides  with  the  apex  of  the 
cone  of  cathodal-rays  from  the  concave  mirror,  and  these  rays, 
moreover,  strike  it  at  an  angle  of  4*;°.  Since  every  solid  body 
struck  by  the  cathode- rays  becomes  the  source  of  Roentgen-rays, 
these  latter  are  emitted  at  once  from  the  focus-point  on  the  anti- 
cathode.  This  point  emits  X-rays  in  all  directions,  though  most 
powerfully  in  the  half  of  the  tube-space  corresponding  with  the 
cathode.  (Emission  of  X-rays,  however,  takes  place  in  the  op- 
posite direction  as  well,  through  the  platinum-plate  of  the  anti- 
cathode.  The  fluorescent  screen  at  once  proves  that  the  rays  are 
evolved  also  from  the  dark  half  of  the  tube.  The  glass  walls  of 
the  tube  and  the  secondary  anode  also  emit  X-rays.)  By  this  ar- 
rangement excessive  heating  within  the  tube  is  obviated.  The 
anti-cathode  in  these  tubes  is  generally  so  arranged  that  by 
means  of  a  connection  with  the  anode  it  may  be  turned  into  a 
secondary  anode.  Thereby  the  tendency  towards  destruction  of 
the  platinum  is  minimised. 

In  many  tubes  (those,  for  instance,  of  the  Allg.  Elektricitats- 
Gesellschaft,  Berlin),  while  the  cathode  is  made  as  above  de- 
scribed, the  anode  itself  is  made  to  form  the  anti-cathode  by 
making  it  carry  a  platinum  mirror  set  at  an  angle  of  45°,  from 
which  the  X-rays  emanate.  If,  however,  the  anti-cathode  is 
made  to  work  in  this  way  as  anode  also,  the  tube  soon  becomes 
blackened  by  the  dispersion  and  precipitation  of  platinum-par- 
ticles on  the  vessel-wall;  this  does  not  occur  where  the  anti- 
cathode  is  insulated.  The  coating  of  platinum-particles  has  an 
affinity  for  absorbing  gases,  and  so  seizes  on  the  traces  of  air 


TREATMENT  JFITH  X-RAYS 


203 


left  within  the  tube.  According  to  JJ'ild,  the  cause  of  this  dis- 
persion of  platinum-particles  from  the  anti-cathode  is  explained 
by  the  fact  that  the  latter  is  always  surcharged  with  negative 
electricity,  and  becomes,  indeed,  a  secondary  cathode,  which  de- 
velops its  own  rays.  These,  according  to  the  "bombardment- 
theory,"  are  a  current  of  material  particles  flung  off  by  the 
cathode.  The  ^'penetrator"  of  Messrs.  Watson  ^  Sous  is  a 
globe  with  two  long  tube-shaped  processes  which  contain  the 
electrodes.  The  cathode  is  shaped  like  a  concave  mirror,  and 
the  anode-wire,  which  terminates  in  a  ring,  is  placed  in  a  sep- 
arate glass  tube.  A  prolongation  from  the  latter  supports  a 
platinum  mirror  (the  anti-cathode),  which  is  thus  insulated 
from  the  anode-wire.     The  cone  of  cathode-rays  has  to  pass 


^ 


Fig.  62. 
(From  A.  Loiidc,  i  c,  p.  64. 


through  the  anode-ring  before  it  strikes  the  anti-cathode  (Fig. 
62). 

Richard  MiieUer-Uri  of  Brunswick  constructed  a  Roentgen 
tube  giving  its  effect  within  a  small  and  strictly  limited  area  and 
with  small  current-quantities.  The  cathode,  supported  on  a  long 
stem,  is  contained  within  the  cylindrical  part  of  the  tube.  The 
anode — an  aluminium  ring — is  placed  in  the  middle  or  wider 
part  of  the  tube.  Opposite  to  it  the  secondary  anode  (reflec- 
tor) is  fixed;  this  is  contained  within  the  globular  end  of  the 
tube,  which  is  cone-shaped.  The  peculiarity  of  the  tube  consists 
in  this  situation  of  the  reflector  at  one  side,  with  its  finger-like 
encasement.  The  rays  from  it  act  only  upon  an  area  the  size  of 
a  thumb-nail.  The  efficiency  of  an  X-ray  tube  is  limited  by  the 
fact  that  when  the  cathode-rays  have  attained  a  certain  intensity, 
the  anti-cathode  gets  red-hot.     As  a  result  of  this  the  glowing 


204  RADIO-THERAPY 

platinum  parts  with  a  certain  amount  of  absorbed  gas,  whereby 
the  degree  of  vacuum  in  the  tube  becomes  altered.  Again  the 
dispersion  of  the  platinum  in  the  form  of  fine  particles,  as  men- 
tioned above,  is  considerably  augmented.  By  these  two  means 
the  tube  is  gradually  rendered  useless;  and  it  is  not  always  safe, 
therefore,  to  work  the  coil  at  its  full  capacity  and  so. supply  to 
the  tube  more  energy  than  it  can  properly  deal  with.  In  order 
to  prolong  the  "life"  of  a  tube,  F.  Kiirlbaiim  ^)  covers  the  anti- 
cathode  with  platinum-black.  This  material  parts  with  heat 
much  more  freely  than  sheet  platinum,  and  therefore  is  much 
less  liable  to  become  red-hot. 

Many  makers,  with  the  idea  of  obviating  this  excessive 
heating  of  the  anti-cathode,  construct  the  latter  of  comparatively 
large  blocks  of  copper  {voltohm  tubes)  ^  or  provide  it  with  a 
layer  at  the  back  consisting  of  some  substance  which  has  a 
greater  heat-capacity  and  a  larger  radiating-surface  {Max 
Levy,  Dessauer) .  This  black  layer  of  insulating  material  (porce- 
lain) is  intended  on  the  one  hand  to  retain  the  heat,  so  that 
the  platinum-mirror  gets  into  the  glowing  state,  in  which  it 
evolves  the  greatest  quantity  of  highly-penetrative  rays.  At 
the  same  time  this  kind  of  anti-cathode,  even  when  heated,  only 
parts  with  very  small  quantities  of  gas,  so  that  the  vacuum  is  not 
altered  very  much.  Max  Levy  believes  that  a  second  function 
of  the  insulating  material  is  to  be  found  in  its  power  of  storing  a 
large  portion  of  the  energy  developed  on  the  anti-cathode. 

In  order  to  cope  with  powerful  current-supplies  having  rap- 
idly-succeeding interruptions — such  as,  for  instance,  obtain  when 
using  the  electrolytic  interrupter — tubes  have  been  made  with 
cooling-chambers  adjoining  the  anti-cathode.  These  chambers 
contain  cold  water,  which  absorbs  the  surplus  heat,  and  moreover 
tends  considerably  to  diminish  the  dispersion  of  the  platinum. 
The  water  in  tubes  of  certain  kinds  is  kept  circulating  through  a 
system  of  tubing,  whereby  a  stream  of  cold  water  is  constantly 
in  relation  with  the  anti-cathode.  In  another  and  still  better 
system  the  anti-cathode  is  formed  by  a  platinum-mirror  fixed  at 
the  bottom  of  a  glass  vessel  containing  water.    The  water  does 


')  Elektrotcch.  Zeitschr.,   igoo,  p.  237. 


TREATMENT  fVITH  X-RAYS  205 

not  require  renewing,  since  the  tube  works  efficiently  even  with 
the  water  at  boihng-point  {Dr.  J!\ihir,  Fig.  65). 

These  appliances  prevent  in  a  great  measure  any  increase  in 
the  vacuum  of  a  tube,  which  would,  other  things  being  equal, 
be  inevitably  accompanied  by  some  loss  of  efficiency.  For  if  the 
platinum  be  allowed  to  glow  very  much,  it  has  a  well-known 
tendency  to  absorb  gases  on  cooling,  and  so  heighten  the 
vacuum  ^).  Now  the  quality  of  the  X-rays  depends  very  largely 
upon  the  degree  of  the  tube's  vacuum.  With  the  heightening  of 
the  latter  the  tube  is  said  to  become  "hardened";  it  offers  a 
greater  resistance  to  the  passage  of  the  discharge,  and  while  the 
radiation  gains  thereby  in  intensity,  it  also  gains  in  penetrative 
power.  If,  for  instance,  working  at  a  certain  vacuum,  the  tube 
gives  a  sharp  silhouette  of  the  hand  (since  the  X-rays  only  pen- 
etrate the  fleshy  parts,  but  are  absorbed  by  the  bones,  as  is  the 
case  with  soft  tubes),  it  will  be  found  on  increasing  the  vacuum 
that  one  obtains  rays  which  penetrate  all  the  tissues  almost 
equally  well,  whereby  constant  effects  become  lost  (hard  tubes) . 
We  see,  therefore — a  fact  which  was  soon  discovered  in  X-ray 
work — that  by  varying  the  degree  of  vacuum,  we  can  also  vary 
the  penetrative  capacity  of  the  rays. 

Edcr  and  Valenta  -)  observed  in  1896  that  the  effectiveness 
of  tubes  varied  with  their  degree  of  vacuum;  Porter'^)  classi- 
fied X-rays  as  follows :  Rays  which  penetrate  the  flesh  easily  but 
bones  with  difficulty  (Xi-rays)  ;  those  which  are  largely  ab- 
sorbed by  flesh  (X.-rays)  ;  and  those  which  penetrate  both 
bones  and  flesh  equally  well  (X-rays). 

Albers-Schoenberg'^)  recognised  four  degrees  of  vacuum: 
I,  hard  (grey)  ;  2,  medium-soft  (grey-black)  ;  3,  soft  (deep- 
black)  ;  4,  very  soft  ^) ,  Here  the  intensity  of  the  shadow  of  the 
metacarpal  bones  on  the  fluorescent  screen  is  taken  as  an  index. 


')  With  a  high  degree  of  vacuum  the  tul^e  sometimes  explodes  under 
the  atmospheric  pressure. 

^)  Versuche  ueher  die  Photograpliic  mittclst  dor  Roentgen  Stralilcn. 
Wien  und  Halle.  1896.  p.  5.     Anm. 

')  Cit.  hei  E.  Valenta,  Oe.st.  Chemikerztg..  1.  Nr.   i.  1898. 

*)   Fortschr.  a.  d.  Geb.  d.  Roentgenstr.,  Bd.  Ill,  H.  4.  p.   143. 

°)  Kienbocck  distinguishes  yet  another,  a  fifth  grade,  the  "over-hard" 
tube.     (Wr.  Klin.  Woch.,  1900,  No.  50.) 


2o6  RADIO-THERAPY 

Contrasts  are  more  with  "soft"  tubes,  as  mentioned  above,  than 
with  hard  ones.  According  to  Gassmann  and  Schenkel,^)  the 
degree  of  hardness  of  a  tube  is  best  determined  by  means  of  the 
skiameter.  This,  however,  only  measures  the  penetrative  power 
of  the  rays,  and  not  their  intensity.  Two  tubes  having  an  iden- 
tical penetration  capacity  may  act  very  differently  upon  a  pho- 
tographic plate ;  moreover,  one  and  the  same  tube,  given  a  fixed 
degree  of  hardness,  produces  very  different  radio-chemical  ef- 
fects when  worked  with  different  strengths  of  currents.  In  order 
to  estimate  their  intensity,  one  is  obliged  to  examine  the  effect  of 
the  rays  on  the  fluorescent  screen.  Gassmann  and  Schenkel  pro- 
pose gauging  the  skiameter  by  having  the  tin-foils  of  a  de- 
termined thickness  and  counting  the  number  of  foils  required 
to  just  block  out  the  rays.  Of  course,  the  apparatus  would  have 
to  be  worked  at  a  ciefinite  distance,  say  30  cm.,  from  the  anti- 
cathode.  Benoist  (seep.  245)  constructed  his  radio-chro- 
mometer  very  much  on  these  lines. 

Acting  upon  the  hypothesis  that  the  degree  of  pene- 
tration of  X-rays  for  different  bodies  depends  not  only 
upon  their  thickness,  but  upon  their  atomic  weight,  the 
author  has  for  some  time  past  been  engaged  in  the  con- 
struction  of  an   instrument  consisting  of  a   graduated 
series  of  substances  of  different  atomic  weights  for  this 
purpose. 
W.  Kaiifmann  ^)    found  that  the  velocity  of  the  cathode- 
ray  particles  is  proportional  to  the  square-root  of  the  tension- 
difference  between  anode  and  cathode. 

Since  in  order  to  work  hard  tubes  higher  tensions  are  re- 
quired, it  may  be  presumed  that  in  these  tubes  the  cathode-ray 
particles  move  with  considerable  higher  velocity  and  conse- 
quently bound  with  greater  force  against  the  anti-cathode  than  is 
the  case  with  soft  tubes. 

It  must  be  here  noted  that  the  degree  of  hardness  of  many 
tubes  alters  perceptibly  during  their  use;  moreover,  the  extent 
and  time  of  the  appearance  of  this  change  varies  with  different 


')   Fortschritte  auf  dem  Gebiete  der  Roentgenstrahlen,  Bd.  II,  H.  4,  p.  131- 
^)   Wiedemann's  Ann.,  61,  544,  1897,  and  62,  596,  1898. 


TREATMENT  jriTH  X-RAYS 


207 


tubes  and  apparatus,  so  that  no  hard  and  fast  rule  can  be  laid 
down  as  to  the  degree  of  hardness  permissible  for  radio-therapy. 

The  glass  wall  of  a  tube  absorbs  a  considerable  amount  of 
the  rays,  thereby  diminishing  their  effect.  In  order  to  do  away 
with  this  loss,  Colardcau  made  a  tube  in  which  the  site  where 
the  rays  are  emitted  is  only  iV  millimeter  thick.  The  life  of  the 
tube  is  further  prolonged  by  a  communicating  side-chamber  of 
great  capacity  (Fig.  63). 

The  Allgemcin.  Elcktricilat'lsircscllsc/icift  also  construct  a 
tube  having  a  very  thin  wall  where  the  rays  appear  and  have 


Fig.  63. 
Colardcau's  tube. 


their  greatest  intensity.  This  region  lies  at  right  angles  to  the 
axis  of  the  tube. 

At  Stuetzerbach  in  Thiiringen,  Messrs.  Grciuer  ^  Fricd- 
richs  make  tubes  of  borax-glass,  which  are  very  transparent  to 
X-rays  and  fluoresce  with  a  blue  colour;  while  Seguy  and  Gunde- 
lach  make  theirs  of  a  glass  containing  powdered  potter's  earth 
and  "chlordidymium."  This  glass  fluoresces  red,  and  allows 
double  the  ordinary  amount  of  rays  to  pass. 

After  prolonged  use  a  Roentgen-tube  begins  to  lose  in  effect- 
iveness. This  is  partly  due  to  the  electro-static  charging  of  the 
tube-wall,  a  fact  which  is  readily  proved.  It  has  been  supposed 
that  the  gas-molecules  within  the  tube  are  driven  towards  the 


2o8  RADIO-THERAPY 

wall  as  a  result  of  electro-static  attraction,  whereby  the  central 
part  of  the  tube  becomes  of  higher  vacuum.  Efforts  have  there- 
fore been  made  to  obviate  this  change  of  vacuum  by  removing 
the  electro-static  charge. 

Porter,^)  with  this  object  in  view,  placed  a  wire  ring  around 
the  tube  In  the  plane  of  the  cathode-mirror.  This  ring  was 
brought  as  near  as  possible  to  the  outer  surface  of  the  tube, 
without  actually  touching  it,  and  was  "earthed"  by  means  of  a 
connecting  wire. 

By  this  arrangement  constant  discharge  from  the  tube-wall 
is  effected.  The  same  result  is  attained  by  covering  the  cathodal 
part  of  the  tube  with  tin-foil  and  fitting  an  "earthed"  wire  ring 
over  the  latter,  or  again  by  covering  the  cathodal  region  with  a 
wooden  cylinder,  whose  inner  wall  is  kept  moist. 

Other  means  are  also  available  for  prolonging  the  life  of  the 
tube.  Thus  the  air-molecules  attracted  to  the  metallic  coating 
of  the  tube-wall  may  be  dispersed  by  warming  the  latter.  This 
method,  however,  proves  effective  only  for  a  few  times  and  for 
short  periods. 

Again  the  so-called  adjustable  tubes  have  been  constructed, 
which  are  founded  on  two  systems.  In  the  first  of  these,  sub- 
stances are  placed  within  the  tube,  or  side-chamber,  which  give 
off  gases  on  being  heated. 

Crookes  varied  the  tube  vacuum  by  means  of  a  piece  of 
caustic  potash  in  a  side-chamber.  This  absorbs  the  last  traces 
of  moisture  left  within  the  tube,  thus  raising  the  vacuum.  On 
heating  the  potash,  however,  a  certain  amount  of  vapour  be- 
comes liberated,  whereby  the  vacuum  can  be  lowered.  In  the 
latest  tubes  of  this  class,  the  heating  of  the  potash  is  effected 
automatically  through  the  agency  of  the  discharge-spark,  which, 
when  the  vacuum  is  too  high,  jumps  across  and  outside  the  tube. 

In  the  "Queen  self-regulating-tube"  made  by  Queen  ^ 
Co.  of  Philadelphia,  also  in  those  of  C.  F.  Mueller  of  Ham- 
burg, and  E.  Ducretet  of  Paris  (Fig.  64), there  is  some  caustic 
potash  placed  within  a  secondary  tube  R,  which  is  attached  to 
the  main  tube.     When  the  vacuum  in  the  latter  becomes  too 


*)  Nature,  54,  149,  1896. 


TREATMENT  fFlTH  X-RAYS 


209 


high,  there  is  too  much  resistance  ottered  here  to  the  passage  of 
the  current  from  the  poles  ./  and  A.  Conscciucntly  the  current 
passes  through  /  to  the  side-tube,  which  is  also  a  \acuum-tube  in 
which  ;;/  represents  the  cathode.  The  apex  of  the  cathodal-ray 
cone  from  w  coincides  with  R,  whereby  the  caustic  potash  be- 
comes heated  and  emits  vapour;  this  vapour  passes  into  the  main 
tube  and  so  lowers  its  vacuum  and  resistance.  An  adjustable  lever 
E  is  in  connection  with  the  side-circuit,  which  permits  the  intro- 
duction of  a  larger  or  smaller  spark-gap.  With  the  lever  at  some 
distance  (5  to  7  cm.)  from  the  cathode  of  the  main  tube,  the 
latter  works  "harder,"  at  a  less  distance  (1-3  cm.)  we  have  a 
constantly  lower  vacuum,  and  the  tube  works  "softer."  At  any 
time  when  the  resistance  of  the  main  tube  becomes  greater  than 


Fig.  64. 


that  of  the  spark-gap  the  current  passes  through  the  side-circuit 
and  heats  the  potash.  The  presence  of  sparks,  therefore,  in  the 
spark-gap  shows  that  the  automatic-regulating  process  is  pro- 
ceeding. 

In  the  latest  types  of  tube  made  by  T.  //.  /-'.  MncUcr  of 
Hamburg  (Fig.  65)  a  loop  is  attached  to  the  lexer  C  W)  this, 
if  it  be  required  to  quickly  lower  the  \acuum,  the  negatixe  pole 
of  the  coil  is  directly  attached,  so  that  the  current  can  be  sent  in 
its  full  force  through  the  secondary  tube.  It  is  generally  ad\is- 
able,  however,  to  begin  with  weaker  currents. 

l"he  last-mentioned  tube  has  also  a  de\ice  lor  "hardening" 
it.     This  is  useful  when  the  "softenin«j;"  has  by  accident  been 


2IO 


RADIO-THERAPY 


carried  too  far.     In  order  to  harden  the  tube,  the  positive  wire 
from  the  coil  is  not  connected  with  the  secondary  anode  G  of 

the  main  tube,  but  with  the 
spiral-shaped  electrode  /  of 
the  side-tube,  care  being  taken 
that  the  brass  lever  E  is  not 
in  contact  with  the  cathode  K. 
If  now  the  current  be  turned 
on  (in  the  same  direction  as 
for  softening),  metallic  par- 
ticles from  the  spiral  /  are 
freely  driven  off  against  the 
wall  of  the  side-tube,  whereby 
some  of  the  gaseous  contents 
of  both  tubes  become  also 
bound  to  the  vessel-wall  and 
the  vacuum  of  the  main  tube 
is  raised. 

Another  method  of  control- 
ling the  vacuum  tubes  is 
founded  on  the  principle  of 
osmosis. 

Here  one  utilises  the  property  which  heated  platinum 
possesses  of  being  penetrable  by  hydrogen.  For  this  purpose 
the  main  tube  carries  a  side-chamber  terminating  in  a  platinum 
tube  closed  at  the  end  (Fig.  66).  If  the  vacuum  be  too  high, 
one  heats  this  platinum  over  a  Bunsen-  or  spirit-flame  till  it  be- 
comes red-hot.  Hydrogen  gas  from  the  flame  now  permeates 
the  platinum  and  so  gains  access  to  the  interior  of  the  main 
tube,  the  vacuum  of  which  is  thereby  lowered.  This  process 
may  be  carried  out  while  the  tube  is  working,  so  that  the  degree 
of  vacuum  can  be  gauged  by  the  colour  of  the  fluorescence. 
When  the  latter  begins  to  show  a  bluish  tint  the  heating  opera- 
tion should  be  suspended,  for  now  the  vacuum  is  evidently  very 
low.    According  to  B.  f Falter'^)    and  Lester  Leonard,-)    the 


Fig.  65. 


^)   Fortschritte  auf  dem  Gebiete  der  Roentgenstrahlen.  Bd.  I,  p. 
^)  Ann.  d'electrobiolog.,  Bd.   Ill,  p.  481. 


TREATMENT  WITH  X-RAYS 


21  I 


degree  of  vacuum  of  a  Roentgen  tube  may  be  at  once  gauged 
from  the  spark-length  of  the  electrical  tension  necessary  for  its 
excitation,  so  that  one  may  speak  of  the  "spark-length"  of  such  a 
tube.  Since  the  electrical  resistance  of  a  tube  depends  upon  its 
vacuum,  while  the  same  factor  controls  the  penetrating  power 
of  the  rays,  one  will  in  the  measure  of  the  resistance  possess  also 
a  relative  measure  of  the  quality  of  the  X-rays.  The  spark- 
length  of  the  coil  supplies  this  measure,  since  the  spark  jumps 
across  the  secondary  current-circuit  and  is  parallel  to  the  dis- 
charge-path within  the  tube.     (See  Spintemeter,  page  245.) 

The  metallic  lever  on  the  automatically-regulated  tube 
(Figs.  64,  65)  affords  a  means  of  varying  the  vacuum  of  the 
tube  by  modifying  the  resistance  of  the  secondary  current-cir- 
cuit, which  again  influences  the  resistance  and  the  vacuum  of 
the  tube.    As  the  lever  approaches  or  recedes  from  the  cathode, 


Fig.  66. — Friedrich   Dcssmicr's  adjustable   lube. 


the  resistance  in  the  secondary  current-circuit  is  accordingly  in- 
creased or  diminished. 

By  using  a  self-regulating  tube  one  can  work,  throughout 
the  expose,  with  X-rays  which  are  of  even  ijuality.     According 


212 


RADIO-THERAPY 


to  Leonard,  a  "soft"  tube  corresponds  to  a  spark-length  of  2-5 
cm.  at  the  coil;  it  allows  a  current  of  great  energy  to  traverse  it. 
The  same  authority  defines  a  ''hard"  tube  as  one  requiring  a 
spark-length  of  5  cm.  and  more  at  the  coil.  It  sometimes  hap- 
pens that  on  reducing  the  vacuum  of  an  over-hard  tube  the  proc- 
ess is  carried  too  far  and  the  tube  made  too  soft.  Such  a  tube 
is  useless  for  work  with  a  JJ'eJinclt's  interrupter.  On  first  clos- 
ing the  circuit,  a  temporary  yellowish-green  illumination  of  the 
tube  is  seen,  with  violet  circles  and  shadows,  but  after  that  there 
is  no  further  fluorescence.  The  author  has  remedied  this  defect 
by  lengthening  the  platinum-pin  of  the  interrupter;  or  should 
this  prove  ineffective,  by  placing  another  tube  (a  hard  one)  in 
front  of  or  behind  the  over-soft  one.  On  sending  a  strong  cur- 
rent through  both  tubes,  at  first  a  slight  violet  glimmer  is  seen 
in  the  soft  one.  Later  on  a  violet  line  appears  between  cathode 
and  anti-cathode,  and  this  is  succeeded  by  greenish  fluorescence 
which  gradually  gains  in  intensity,  the  violet  being  lost;  when 

this  happens  sparks  appear  in 
the  spark-gap  of  the  coil.  By 
serial  connection  of  hard  and 
soft  tubes  in  this  way  the  author 
has  moreover  at  times  succeeded 
in  restoring  over-hard  tubes. 
Very  hard  tubes  can  also  be  got 
to  work  for  a  time  by  removing 
the  wire  connecting  anode  and 
anti-cathode. 

The  adjustable  tubes  made 
by  //'.  A.  H'lrschman  and  Max 
Levy  of  Berlin  are  founded 
on  another  principle.  In  these 
there  is  a  contrivance  where- 
by minute  quantities  of  air  are 
allowed  to  enter  the  tube  when 
it  has  become  over  -  hard. 
Fig.  67  represents  such  a 
tube.  By  turning  the  valve-screw  T\  which  is  kept  tightly  closed 
at  other  times  by  atmospheric  pressure,  a  minute  quantity  of 


Fig.  67. — Roentgen-tube,    by    W. 
A.    Hirschmann,    Berlin. 


TREATMENT  f/lTH  X-RAYS  213 

air  gains  access  to  the  tube  and  so  softens  it.  These  tubes 
also  possess  an  appliance  E  for  letting  air  escape  from  them, 
whereby  it  is  possible  to  harden  soft  tubes  while  they  are  work- 
ing. This  is  managed  simply  by  lifting  the  spring  F  with  a 
glass  rod  away  from  G  till  no  sparks  jump  across.  The  globe  E 
is,  it  should  be  mentioned,  coated  with  a  layer  of  finely-divided 
platinum,  which  absorbs  air  while  the  current  is  passing. 

The  anti-cathode  is  in  this  tube  provided  with  a  water  cool- 
ing chamber  L.  If  the  character  of  the  X-rays  changes,  the 
situation  of  the  focus-point  of  the  cathode-rays  will  also  change. 
The  ideal  is  to  have  one  point  on  the  anti-cathode,  which  is  at 
the  same  time  both  the  focussing-point  of  the  rays  coming  from 
the  concave  mirror  and  the  point  of  origin  of  the  X-rays.  In 
most  tubes,  however,  the  X-rays  do  not  emanate  from  a  point 
on  the  anti-cathode,  but  from  a  surface  of  variable  size.  This 
surface  is  at  its  smallest  when  the  tube  possesses  a  certain  de- 
gree of  vacuum.  The  need,  therefore,  existed  for  some  arrange- 
ment whereby  the  cathode-rays  could  be  accurately  focussed  at 
one  point  in  the  anti-cathode.  Moreover,  the  X-rays  must  pro- 
ceed from  one  point  only,  and  this  point  must  remain  fixed,  even 
though  the  penetrating  capacity  of  the  ravs  may  alter.  For 
exact  work  again  those  rays  which  exist  apart  from  the  main 
body  of  rays — the  so-called  "wandering  rays" — must  be  elimi- 
nated, and  one  should  be  able  to  regulate  the  quality  and  the 
penetrating  capacity  of  the  rays  during  the  expose  as  desired, 
and  that  without  admitting  or  expelling  air. 

With  these  ideals  in  view,  a  tube  has  been  constructed  by 
Gundelacli  and  Dessaiicr.  Gundelach  utilises  an  observation 
made  by  Hittorf  and  Piiliij  to  the  effect  that  the  static  charge  of 
a  glass  tube  hinders  the  free  passage  of  the  cathode-rays.  When 
cathode-rays  traverse  a  tube  the  latter  becomes  statically 
charged,  whereby  the  progress  of  further  cathode-rays  is  im- 
peded. If  the  tube  be  narrow,  the  cathode-rays  may  be  alto- 
gether suppressed.  If,  however,  it  be  somewhat  wider  the  rays 
pass  through,  keeping  as  far  away  as  possible  from  the  sides  of 
the  tube  and  becoming  concentrated  into  one  single  ray  which 
runs  in  the  line  of  the  tube's  axis.  This  concentrated  ray  will 
strike  the  anti-cathode  somewhere,  and  X-rays  will  be  evolved 


214 


RADIO-THERAPY 


with  almost  mathematical  precision  from  this  point.  Gundelach 
placed  a  metallic  covering  over  his  tube,  which  considerably 
heightens  the  effect.  This  metallic  mantle  has  another  function. 
The  site  where  the  X-rays  strike  it  has  an  area  about  the  size  of 
a  pfennig-piece.  This  area  allows  all  the  regular  rectilineal  rays 
to  pass,  but  completely  obliterates  all  "wandering"  rays. 

F.  Dessaiier  had,  however,  noticed  that  the  quality  of  the 
rays  changes  in  certain  tubes  according  to  whether  one  uses  the 
anti-cathode  and  secondary  anode  conjointly  or  not.  In  the 
former  case  some  tubes  were  considerably  softer. 

Acting  on  this  observation,  tubes  were  made  (Fig.  68)  with 
a  variable  spark-resistance  between  the  external  poles  of  the  anti- 


Adjustable  tube  by  Gundelach  and  Dessauer. 


cathode  and  anode.  By  means  of  a  vulcanite  handle  the  spark- 
gap  could  be  increased  or  diminished,  so  that  any  desired  cur- 
rent-quantity could  be  supplied  to  the  secondary  anode  and  the 
penetrating  capacity  of  the  rays  controlled. 

Wild  and  Walter^)  have  shown  that  Roentgen-tubes  are 
adversely  affected  by  the  closing  currents  of  the  coil,  which  give 
wrong  current  direction.  The  presence  of  this  reversed  closing- 
current  is  shown  by  the  interspersion  of  spots,  rings,  and  shadows 
in  the  green  fluorescence  of  the  tube. 

Experience  soon  showed  that  in  order  to  be  able  to  properly 
regulate  soft  tubes,  as  well  as  to  free  them  from  closing-current 


')   Fortschritte  auf  dem  Gebiete  der  Roentgenstrahlen,  Bd.  II,  p.  60. 


TREATMENT  JIITH  X-RAYS  21; 

effects,  the  primary  coil  should  be  constructed  with  variable  self- 
induction.  The  latter  can  then  be  readily  increased  for  these 
soft  tubes  ^ ) . 

¥ov  this  purpose  coils  are  made  as  directed  by  B.  ITallcr,  in 
which  the  primary  winding  is  composed  of  several  sections.  By 
means  of  a  special  cross-connecting  arrangement  the  current  may 
be  made  to  flow  through  one,  or  to  increase  the  self-induction, 
through  two  or  more  of  the  sections. 

Another  method  of  banishing  the  closing-currents  from  the 
tube  consists  in  introducing  the  so-called  Drosscl  tubes  to  the 
secondary  current-circuit  of  the  coil.  I'he  cathode-rays,  accord- 
ing to  Piiliij,  that  is  to  say,  the  electric  discharges  in  a  vacuum- 
tube  possessing  a  free  and  an  enclosed  electrode,  go  only  from 
the  latter  to  the  former,  since  a  greater  resistance  is  opposed  to 
the  passage  of  a  discharge  in  the  reversed  direction.  The  Dros- 
sel-tube  takes  advantage  of  this  fact.  It  offers  no  special  re- 
sistance to  the  "opening"  induced  currents,  but,  on  the  other 
hand,  "closing"  currents,  which  pass  in  the  opposite  direction, 
are  practically  suppressed. 

The  Drossel-tube  is  connected  directly  to  the  Roentgen-tube, 
being  itself  in  connection  with  the  positive  wire  from  the  coil. 
As  a  rule,  the  Drossel-tube  itself  is  provided  with  an  appliance 
for  regulating  its  vacuum.  {Dr.  Max  Levy's,  F.  Dcssaiicrs  and 
Chabaud's  tubes.) 

The  author's  own  experience  with  Roentgen-tubes  leads  him 
to  prefer  those  which  are  regulated  on  the  "osmosis"  principle. 
These  tubes  he  has  found  practically  indestructible,  and  has  in- 
deed had  two  of  them  in  constant  use  for  ji\e  months,  working 
daily  for  several  hours,  without  finding  them  suffer  any  dete- 
rioration. He  has  found  the  ordinary  non-adjustable  short-lived 
tubes  so  very  troublesome  that  he  has  discontinued  using  them. 

I   28.    Some    Practical    Hints   on   the    Installation   and    Use 
of  X-Ray   Apparatus. 

When  buying  an  X-ray  outfit,  the  current  source  must  be  the 
first  consideration.     Primary  currents  are  no  longer  used.     Most 


'>   Sec  page  62  fT. 


2l6 


RADIO-THERAPY 


tubes  are  now  worked  by  accumulators,  or  by  currents,  contin- 
uous or  alternating,  from  the  town  supply.  In  rare  instances 
static  machines  (see  p.  17)  are  used  to  supply  the  current,  and 
here  the  installation  is  perhaps  the  simplest.  These  generators, 
however,  cannot  as  a  rule  be  recommended  on  account  of  their 
comparatively  feeble  capacity. 

Presuming  some  system  of  accumulators  to  be  selected,  the 
first  thing  to  ascertain  is  what  current-strength  and  what  tension 
are  required  by  the  coil.  Supposing  1 2  volts  to  be  necessary,  at 
least  6  cells  must  be  provided.  It  is,  however,  better  to  use  an 
accumulator  somewhat  larger  than  this,  as  small  accumulators 
suffer  if  too  great  a  demand  be  made  upon  them.  It  must  be 
remembered  also  that  the  charge  of  the  cells  falls  after  use 
below  2  volts,  and,  moreover,  various  auxiliary  apparatus  has  to 
be  connected  with  the  current-circuit.  The  following  table  of 
the  Allgemeine  Elektricitaets-Gesellschaft,  Berlin,  shows  the 
lowest  tension  necessary  for  a  coil  in  order  to  maintain  the  maxi- 
mum spark-length.  A  mercury-interrupter  is  supposed  to  be 
used  which  interrupts  the  current  18  times  per  second,  the  dura- 
tion of  current-opening  and  current-closing  being  identical. 


Minimum  of 

Cells  required 

in  Battery 

For  Roentg 

en-Ray  Work 

spark-Length 

Minimum 
Tension  in  Volts 

of  Coil  in  Cm. 

Minimum 

Number  of 

Tension 

Cells 

18 

12 

6 

16 

8 

23 

14 

7 

16 

8 

28 

16 

8 

20 

10 

33 

20 

10 

24 

12 

43 

24 

12 

28 

14 

54 

28 

14 

32 

16 

65 

32 

16 

40 

20 

75 

40 

20 

48 

24 

With  a  quicker  rate  of  interruption  more  cells  are  required, 
or  the  coil  will  not  be  worked  at  its  full  capacity. 

Charging  the  Acctiniulators.  This  must  be  done  at  a  certain 
current-strength  only,  which  is  defined  by  the  maker  of  the  cells. 
Primary  elements,  or  a  thermo-pile,  or  a  dynamo-supply,  may  be 
used  for  this  purpose,  but  the  first  two  should  only  be  used  when 
the  last-mentioned  method  is  not  available.     Generally  2  Bun- 


TREATMENT  JFITH  X-RAYS  217 

sen-elements  are  required  to  charge  a  single  cell,  so  that  an 
accumulator  of  6  cells  requires  12  elements  for  charging. 

When  using  a  thermo-pile,  the  battery  requires  first  connect- 
ing with  the  gas-supply,  and  it  is  important  to  see  that  all  the 
lights  are  burning.  Since  a  thermo-pilc  only  furnishes  low-ten- 
sions, the  accumulator  must  be  provided  with  an  arrangement 
whereby  all  the  cells  may  be  connected  in  parallel;  in  this  man- 
ner, as  is  well  known,  the  tension  of  the  battery  is  made  no 
greater  than  that  of  an  individual  element.  After  the  thermo- 
pile has  become  heated,  its  +  terminal  is  connected  with  the  + 
terminal  of  the  accumulator;  the  —  terminals  are  similarly 
joined.  Charging  an  accumulator  in  this  way  takes  a  consid- 
erably longer  time  than  in  the  manner  next  described. 

The  best  method  of  all  is  to  use  the  continuous  current  from 
a  dynamo.  The  poles  on  the  conducting-wires  from  the  latter 
must  be  first  determined.  The  following  chemical  methods  may 
be  adopted  for  pole-finding:  {a)  By  dipping  the  ends  of  the  two 
wires  into  dilute  sulphuric  acid,  say  the  contents  of  a  JVehnclt's 
interrupter.  The  negative  wire  shows  a  free  development  of 
gas,  whereas  the  positive  wire  remains  practically  free  from  gas, 
but  is  coated  with  a  black  deposit  of  copper  oxide,  {b)  By  bring- 
ing both  wires  into  contact  with  a  piece  of  paper  moistened  with 
potassium  iodide  solution.  The  positive  pole  is  indicated  by  a 
black  stain.  IVilke's  "pole-finding  paper,"  which  is  treated  in  the 
same  way,  gives  a  red  stain  at  the  site  of  the  negative  pole.  This 
paper  may  be  purchased  from  the  trade,  bound  in  booklets, 
(c)  A  small  apparatus  can  be  obtained  which  consists  of  a  small 
tube  filled  with  a  liquid  into  which  platinum  wires  project  from 
either  side.  If  these  be  connected  with  the  conducting  wires 
the  liquid  becomes  dyed  red  at  the  negative  pole.  The  colour 
disappears  on  shaking  the  tube. 

When  the  pole  signs  are  not  marked  on  the  accumulator, 
the  positive  electrode  may  be  known  by  its  brown,  and  the  nega- 
tive by  its  grey  colour.  Care  must  be  taken  when  charging,  that 
the  positive  and  negative  electrodes  are  in  connection  with  the 
corresponding  terminals  of  the  supply  current. 

In  order  to  protect  the  accumulator  from  damage  by  too 
strong  a  supply-current,  a  rheostat  and  amperemeter  must  be 


2i8  RADIO-THERAPY 

first  introduced  into  the  circuit.  Or  a  series  of  incandescent 
lamps  of  definite  size,  connected  in  parallel,  may  be  used  as  re- 
sistance. In  this  case  no  amperemeter  will  be  required.  The 
current-consumption  of  a  lamp  is  at  the  same  time  a  measure  of 
the  current-strength  which  it  allows  to  pass  through.  If,  for 
instance,  a  lamp  of  the  series  works  at  98  volts  and  25  candle- 
power  and  uses  i  ampere  of  current,  it  will,  where  there  is  par- 


P 


-■i  y.  )C)c ):  ;c 


Fig.  69. — Scheme  for  the  arrangement  of  incandescent  lamps  as  front-resist- 
ances in  the  charging  of  accumulators.     (After  Max  Kohl,  Chemnitz.) 

allel-connection  (Fig.  69),  allow  just  as  much  to  reach  the 
accumulator.    A  second  lamp  passes  a  second  ampere,  and  so  on. 

When  the  accumulator  is  not  properly  connected,  the  lamps 
burn  more  brightly  than  usual.  A  lead-fuse  placed  in  the  cur- 
rent circuit  and  calculated  for  the  maximum  current-strength 
protects  the  lamps  from  destruction. 

As  a  rule  the  current-strength  should  be  maintained  at  an 
even  level  during  the  process  of  charging.  In  no  case  should 
too  great  a  current-strength  be  used,  or  the  cells  will  be  damaged, 
and  towards  the  end  of  the  charging  the  strength  of  the  supply 
should  be  allowed  to  fall  30-50%.  If  too  feeble  a  current  be 
used,  the  time  required  to  charge  the  cells  is  unnecessarily  pro- 
longed. The  charging  of  the  accumulator  must  be  allowed  to 
proceed  until  a  moderate  amount  of  gas  is  developed  in  the  cells. 
Notice  should  be  taken  if  the  formation  of  gas  is  equal  in  all 
the  cells;  should  one  of  them  be  deficient  in  this  respect,  it  will 
probably  be  found  that  short-circuiting  has  occurred,  owing  to 
the  presence  of  conducting  media  between  the  electrodes.  These 
should  be  removed  by  means  of  a  glass-rod,  and  if  the  trouble 
cannot  be  removed  in  this  way  the  cell  should  be  withdrawn. 
Hermetically  sealed  vessels  which  may  enclose  the  electrodes 
should  be  opened  during  the  process  of  charging,  e.  g.,  by  re- 
moving plugs. 

When  discharging  an  accumulator  the  current-strength  used 


TREATMENT  JVITH  X-RAYS 


1\C) 


must  not  be  allowed  to  exceed  certain  limits,  which  are  defined 
by  the  manufacturer.  At  the  beginning  of  the  discharge  the 
tension  of  each  cell  averages  2  volts;  later  on  it  suffers  a  gradual 
decrease,  while  as  the  cell  approaches  the  stage  of  exhaustion 
this  loss  of  tension  becomes  more  rapid.  The  discharge  limit  Is 
reached  when  the  terminal  tension  of  each  cell  drops  to  1.83 
volts.  A  cell  should  never  be  worked  down  to  1.8  volts  or  Its 
durability  will  be  impaired. 

The  following  points  should  also  be  borne  in  mind  when 
working  Roentgen  apparatus  from  accumulators : 

A  fully  charged  accumulator  standing  Idle  discharges  Itself 
In  the  course  of  2-4  weeks;  consequently  it  requires  periodical 
charging  w^hether  In  use  or  not.  The  liquid  in  the  cells  requires 
renewal  from  time  to  time,  either  with  distilled  water,  or  fresh 
acid  and  water  of  the  original  strength. 

Accumulators  must  be  moved  with  great  care  and  guarded 


Fig.  70. — Scheme  for  Roentgen  apparatus  worked  with  accumulators.     (After 
B.  Donath,  c.  p.  91.) 

from  shocks.    They  must  never  be  used  too  long  at  a  time,  and 
must  be  frequently  recharged. 

When  connecting  the  accumulator  with  the  coil   (Fig.  70), 
one  of  the  poles  of  the  battery  is  joined  by  wire  with  one  of  the 


220  RADlO-rHERAPY 

terminals  {nj,)o{  the  primary  coil.  The  second  battery-pole 
should  first  be  connected  with  a  lead-fuse,  the  latter  with  an 
amperemeter  {A p) ,  a  rheostat  (fl\),  and  a  current-interrupter 
(.^i)  which  is  in  connection  with  the  other  terminal  (;/i)  of  the 
primary  coil.  A  volt-meter  {P')  is  arranged  in  a  side-circuit  (par- 
allel), the  function  of  which  is  to  indicate  the  tension  in  the 
accumulator.  For  use  with  a  Necf's  hammer,  the  above  ar- 
rangement is  quite  sufficient,  but  in  most  cases  quicker  inter- 
rupters are  employed  for  therapeutic  purposes,  so  that  the  second 
battery  {B.)  will  be  required  for  working  the  interrupter.  One 
of  the  poles  of  this  battery  is  connected  with  a  terminal  (wi) 
of  the  motor  working  the  interrupter.  Between  the  other  bat- 
tery-pole and  the  second  motor-terminal  {ni.)  a  current-inter- 
rupter {A.)  and  a  rheostat  {JF-i)  are  introduced,  by  means  of 
which  the  rapidity  of  the  interruptions  may  be  regulated.  In 
addition  to  the  terminals  nii  and  m^-,  there  are  three  further  pairs 
of  terminals  at  the  interrupter  board.  Of  these,  the  first  pair,  «i 
and  //m,  receive  the  main  current  for  the  primary  coil,  the  second 
pair,  />!  and  p,^  are  joined  to  the  poles  of  the  primary  coil,  and 
the  third,  /Ci,  Xo,  are  connected  with  the  terminals  of  the  con- 
denser. 

The  condenser  is  in  connection  with  both  sides  of 
the  site  of  interruption,  its  function  being  (p.  57)  to  re- 
ceive the  electrical  quantities  which  are  produced  here 
by  the  extra-current. 

The  switch  between  «i  and  n.>  enables  one  to  change 
the  direction  of  the  current  at  any  time.    The  wires  con- 
necting these  parts  of  the  apparatus  must  be  well-in- 
sulated thick  copper  cables. 
The  apparatus  should  be  worked  with  a  continuous  current 
supply  of  1 10  volts  wherever  this  is  to  be  obtained.    Apart  from 
the  fact  that  a  cheaper  form  of  apparatus  may  be  used  with  a 
lighting-circuit,  no  restriction  is  placed  upon  the  choice  of  an 
interrupter,  and  the  whole  plant  can  be  worked  more  efl^ciently. 
Fig.  71   shows  a  scheme  for  the  arrangement  of  a  Roentgen 
apparatus  worked   from  the  lighting-circuit.      From  the  main 
cable,  shown  at  the  top  and  left-hand  side  of  the  sketch,  two 
wires  branch  off — a  thin  wire  L^  for  working  the  interrupter,  and 


TREATMENT  J/ I  Til  X-RJYS 


221 


a  thicker  wire  /.,  for  the  coil.  Resistances  {J  11'  and  RJI')  and 
switches  (.7)  are  situated  in  the  course  of  both  wires;  /.,.  more- 
over possesses  an  amperemeter  {Ap)  and  a  volt-meter  (/')  in 
a  side-circuit. 

Where  a  JJ\'lniclt's  interrupter  is  used,  the  main  lighting- 
circuit  is  in  direct  connection  with  the  primary  coil   (Fig.  72), 


Fig.  71. — Scheme  for  installation  of  Roentgen  apjiaratus  worked  from  a  con- 
tinuous lighting-current.     (After  B.  Donatli,  1.  c,  p.  96.) 


and  provision  is  only  made  for  a  lead-fuse  (5),  a  rheostat 
(Jff),  an  amperemeter  (///>),  and  a  current-break  (./).  Care 
must  be  taken  that  the  posIti\e  pole  of  the  main  current  is  in 
connection  with  the  platinum  pin  of  the  electrolytic  interrupter, 
the  negative  pole  being  in  connection  with  the  lead  plate  of 
the  same. 

When  working  the  Roentgen  apparatus  with  a  mercury 
break  the  full  current  may  be  used  for  the  motor;  the  tension  of 
the  main  circuit  is,  however,  too  high  for  the  coil  itself. 

High  tensions  cannot  be  employed  because  of  the  excessive 
amount  of  sparking  which  would  occur  at  the  interrupter; 
whereby  the  latter  would  be  soon  destroyed.      MoreoNcr,  with 


222 


RADIO-THERAPY 


high  tensions  the  current-strength  in  the  primary  coil  would 
reach  such  a  dangerous  height  with  each  current-closure  that 
there  would  be  injurious  heating  of  the  coil  and  damage  to  its 


Fig.  ^2. — Scheme  for  an  apparatus  with  electrolytic  break.     (After  B.  Donath, 
c,  p.  96.) 


insulation  {B.  Donath).  Resistances  have  therefore  to  be  pro- 
vided which  are  capable  of  absorbing  the  greater  part  of  the 
energy  supplied. 

To  regulate  the  current-supply,  resistances  are  usually  em- 
ployed which  reduce  the  tension  to  35 — 5  volts  ancf  the  current 
strength  to  about  3  amperes.  As  has  been  before  mentioned, 
the  higher  tension  of  the  main  current  can  be  used  direct  for  the 
motor  of  the  mercury  interrupter.  The  motor  is  situated  in  a 
branch-circuit  from  the  main  (See  Fig.  71).  In  order  to  facil- 
itate their  manipulation,  all  the  connecting,  regulating,  and 
measuring  apparatus  belonging  to  the  Roentgen  outfit  are  gen- 
erally mounted  on  a  wooden  or  marble  slab  fixed  to  the  wall  at 
a  height  convenient  for  the  operator.  In  the  latest  types  of 
Roentgen  apparatus,  with  electrolytic  interrupter  and  variable 
self-induction  for  the  primary  coil,  the  controlling  mechanism 
is  arranged  on  a  small  table,  fixed  on  wheels  so  that  it  can  be 
moved  to  any  place  desired  (Fig.  73).  The  apparatus,  more- 
over, possesses  resistances  which  are  capable  of  the  most  delicate 
regulation,  and  on  the  table  every  combination  can  be  produced 
between  the  various  electrodes  of  the  interrupter. 


TREATMENT  JFITH  X-RAYS 


223 


and  the  difterent  dI\isions  of  the  primary  coil  (apparatus  by 
Siemens  CfT  Halske,  Ricluird  Seifert  ^  Co.,  Max  Kohl,  etc.). 

The  interrupter  may  be  placed  at  some  distance  if  its  noise 
inconveniences  the  patient.  When  working  with  a  turbine-inter- 
rupter the  conducting  wires  from  the  coil  may  be  passed  through 
two  holes  in  the  wall  to  the  vacuum-tube  in  an  adjoining  room, 
where  the  patient  sits.  Thus  all  noise  is  obviated,  and  a  nervous 
patient  is  spared  the  sight  of  formidable-looking  apparatus.  A 
switch  in  the  operating  room  controls  the  whole  apparatus. 

In  case  a  d'Arsoiival-Oiidiii's  apparatus  is  intended  also  to 
be  worked  with  the  X-ray  coil,  the  arrangement  should  be  as 


Fig.   73. — Roentgen  apparatus  by  Siemens  &  Halskc. 


in  Fig.  60.  An  earth-wire  can  be  laid  between  the  two  wires 
going  from  the  secondary  coil  to  the  inner  layers  of  the  Leyden 
jar.     This  earth-connection  should  go  not  to  the  gas,  but  the 


224  RADIO-THERAPY 

water-pipes,  since  the  former  are  often  in  the  vicinity  of  the 
electric-hght  cables. 

The  apparatus  for  the  prociuction  of  uni-polar  discharges 
with  Rii/nnkorff's  coil  will  not  work  with  JVehntU's  interrupter. 
In  cases  where  a  continuous  current-supply  is  not  to  be  had,  but 
where  an  alternating  or  rotary  current  alone  offer,  three  courses 
are  open  for  Roentgen  work:  i.  An  electrolytic  interrupter  may 
be  used.  In  this  case  the  platinum-pin  is  made  a  little  thicker,  to 
cope  with  the  increased  wear  and  tear.  Siemens  cif  Halske 
make  a  If'e/inelt's  interrupter  which  may  be  used  in  direct  con- 
nection with  an  alternating  current-supply.  A  spark-gap  is  in- 
troduced into  the  secondary  circuit,  which  only  allows  the  inter- 
ruptions arising  from  one  phase  of  the  alternating  current  to  in- 
fluence the  tube,  those  of  the  other  phase  being  equalised  in  the 
spark-gap.  2.  By  means  of  a  turbine-mercury-interrupter. 
With  this  apparatus  the  current  is  always  closed  in  one  and  the 
same  half  of  the  current-phase,  so  that  only  waves  of  the  same 
direction  enter  the  primary  coil;  consequently  their  effect  is  iden- 
tical with  that  of  an  interrupted  continuous  current.  As  already 
mentioned,  the  turbine-interrupter  must  be  first  regulated  by 
hand  by  means  of  the  fly-wheel.  7  he  number  of  interruptions 
exactly  equals  the  number  of  periods  of  the  alternating  current. 
3.  The  most  advantageous  plan  is  to  transform  the  alternating 
or  rotary  current  into  a  continuous  current.  This  is  done  by 
means  of  a  motor,  which  is  coupled  to  a  continuous-current 
dynamo;  the  latter  supplies  the  current  for  the  Roentgen  appa- 
ratus. (A  transformer  must  also  be  used  in  case  the  continuous 
current  supply  has  a  very  high  tension,  say  440-500  volts.) 

7  he  commutator  must  always  be  properly  arranged,  so  that 
in  the  spark-gap  of  the  coil  sparks  jump  from  the  point  (anode 
+  )  to  the  centre  of  the  disc  (cathode  — ).  Where  the  commu- 
tator is  wrongly  placed  the  sparks  jump  from  the  edge  of  the 
disc  (see  Fig.  23)  to  the  point. 

7  he  tube  must  be  arranged  so  that  its  anode  is  in  connection 
with  the  positive  pole  of  the  coil,  while  its  cathode  (the  concave 
mirror)  is  joined  to  the  negative  pole. 

The  wires  connecting  the  tube  with  the  coil  may  be  thinner 
than  those  joining  other  parts  of  the  apparatus.     Many  kinds 


TREATMENT  WITH  X-RAYS  225 

of  insulated  wires  are  on  sale  with  the  object  of  preventing  the 
patient  or  operator  from  electric  shocks.  The  author  has  found 
none  of  these  really  effective;  he  now  uses  plain  copper  wire. 
The  only  thing  necessary  is  to  avoid  coming  too  close  to  the 
wires. 

What  should  be  the  position  of  the  tube  with  regard  to  the 
patient?  The  first  thing  is  to  ascertain  where  the  most  effective 
Roentgen-rays  are  evolved  from  the  tube.  This  a  fluorescent 
screen  or  photographic  plate  soon  shows.  By  bringing  either 
of  these  close  to  an  active  tube,  not  only  the  contour  of  the  irra- 
diated field,  but  its  most  intensiv^e  area  can  be  seen.  The  latter, 
in  the  case  of  most  tubes,  lies  round  a  line  proceeding  from  the 
point  on  the  anti-cathode  (coinciding  with  the  apex  of  the 
cathode-cone)  at  right  angles  to  the  tube-axis.  In  some  tubes, 
however,  the  most  active  zone  lies  around  a  line  at  right  angles 
to  the  anti-cathode  itself.  In  the  first  case  the  tube  should  be 
placed  parallel  to  the  object  to  be  exposed,  and  then  moved  until 
the  middle  of  the  sphere  is  exactly  opposite  that  object.  In  the 
second  instance,  the  tube  must  be  turned  until  the  anti-cathode 
is  parallel  with  and  exactly  opposite  the  object. 

An  apparatus  with  the  electrolytic  break  is  easily  placed  in 
action.  Ihe  resistances  at  the  rheostat  are  first  disconnected, 
and  the  length  of  the  platinum-pin  is  regulated  by  means  of  the 
screw  according  to  requirement.  Should  the  interrupter  fail  to 
act  there  may  be  various  causes,  of  which  the  following  are 
amongst  the  commonest. 

a)  7  he  lead-fuse  may  have  melted,  requiring  renewal.  The 
fuse  must  not  be  replaced  by  a  stronger  one,  or  a  copper  wire, 
as  by  so  doing  the  wires  would  become  red-hot  with  too  powerful 
a  current.  The  insulation  of  the  supply-cable  must  be  looked  to 
at  the  first  opportunity. 

A)  A  gas-bubble  may  be  fixed  at  the  platinum  point,  in 
which  case  it  should  be  dislodged  by  tapping  or  shaking  the  lid. 

c)  1  he  tube  may  be  too  soft,  or,  where  no  tube  has  been 
connected,  the  spark-gap  in  tiie  secondary  circuit  may  be  too 
small.  To  obviate  this  difficulty  a  harder  tube  may  be  em- 
ployed, or  the  original  tube  may  be  hardened  by  reversing  its 
position  for  a  few  seconds  (see  also  p.  212). 


226  RADIO-THERAPY 

d)  The  acid  In  the  interrupter  may  be  too  hot,  requiring 
the  addition  of  colder  acid.  The  Hquid  again  may  be  too  con- 
centrated. The  best  proportion  of  acid  is  i  in  20  (1.06  specific 
gravity,  =  8°  Beaume). 

e)  The  porcelain  may  become  too  hollowed  around  the 
platinum-pin  after  prolonged  use,  needing  replacement. 

The  current  must  be  turned  off  at  the  main  switch,  not  at 
the  rheostat. 

When  using  interrupters  which  are  not  actuated  by  the  pri- 
mary current  itself  they  must  first  be  set  going  before  sending 
the  primary  current  through  the  coil.  When  disconnecting  the 
apparatus  the  procedure  must  be  reversed.  Should  it  be  found 
that  the  current  is  passing  in  the  wrong  direction  through 
the  tube  (which  is  at  once  seen  from  the  character  of  the 
fluorescence),  the  current-reverser  must  be  used-  imme- 
diately. 

The  interrupter  may  be  regulated  by  ( i )  altering  the  po- 
sition of  the  contacts  in  the  rheostat  in  the  case  of  turbine-  and 
mercury-jet-interrupters.  (2)  The  make  and  break  may  be 
modified  in  mercury-motor-interrupters  by  raising  or  lowering 
the  mercury  vessel.  (3)  The  intensity  of  the  primary  current 
may  be  regulated  by  means  of  its  own  special  resistance.  The 
following  practical  points  are  important:  No  wires  should  be 
left  lying  about  on  the  floors  or  tables  in  the  operating  room; 
all  wires  which  are  not  in  use  should  be  put  tidily  away,  and  the 
operator  must  not  indulge  in  gesticulations  with  wires  in  his 
hands. 

Wires  from  the  coil  to  the  tube  must  not  be  allowed  to  lie 
against  the  former.  The  coil  should  stand  somewhere  away 
from  the  window,  otherwise  in  the  summer  there  will  be  a  risk 
of  the  sun's  heat  melting  the  paraffin  insulation  of  the  windings. 
If  the  temperature  be  very  high,  the  coil  should  be  cooled  with 
damp  cloths,  or  by  using  an  electric  fan. 

Great  care  should  be  taken  that  the  apparatus  be  not  set 
working  while  anybody  is  busy  with  the  wires;  moreover,  no 
bystander  must  approach  too  near  the  conductors  from  the  sec- 
ondary coil  while  the  latter  is  in  action. 

The  spark-gap  of  the  coil  must  never  be  extended  beyond  its 


TREATMENT  jriTH  X-RAYS  227 

limit  of  capacity,  e\en  with  the  tube  in  position.  Otherwise, 
if  the  resistance  between  the  terminals  be  too  great,  there  is  a  risk 
of  short-circuiting  through  the  insulation  of  the  coil.  It  is  much 
better  to  have  the  spark-gap  somewhat  shorter  than  absolutely 
necessary,  for  in  this  way  a  kind  of  safety-\alve  is  provided;  in 
case  the  resistance  of  the  tube  becomes  too  high,  the  discharge 
does  not  take  its  way  round  the  tube  or  through  the  coil-insula- 
tion, but  hnds  vent  in  the  spark-gap. 

Where  the  platinum  contact  of  a  platinum  break  becomes 
fused,  it  may  be  necessary  to  use  a  Hie  to  the  place,  or  a  fresh 
''hammer"  may  have  to  be  provided.  The  motor  working  a 
mercury-interrupter  requires  cleaning  and  oiling  daily.  When 
not  in  use,  the  copper  rod  dipping  Into  the  mercury  must  be 
removed  from  the  latter — otherwise  an  amalgam  will  form. 
Plugs  of  cotton-wool  should  be  placed  in  the  oil-holes  to  prevent 
them  leaking.  The  motors  should  be  seen  to  from  time  to  time, 
lest  they  get  overheated.  Ibis  may  happen  if  they  are  worked 
too  long  at  a  stretch,  especially  if  too  strong  a  current  be  used; 
the  result  may  be  some  damage  to  the  insulation.  Again,  if  a 
layer  of  spirit  be  used  over  the  mercury  in  a  mercury-break,  there 
is  some  danger  of  it  becoming  ignited.  The  author  has  found 
water  better  to  use  for  this  purpose.  Not  only  is  it  free  from 
risk  of  firing  as  compared  with  spirit  or  petrol,  but  the  appara- 
tus is  more  easily  cleaned  afterwards.  This  is  readily  done  by 
placing  the  mercury-vessel  under  a  strong  jet  of  water,  which 
washes  the  muddy  accumulation  away  and  lea\'es  the  mercury 
clean.      This  process  should  be  repeated  daily. 

A  turbine-interrupter  does  not  re(]uire  cleaning  quite  so 
often;  once  a  fortnight  should  suffice.  1  he  pure  alcohol  should 
first  be  poured  oft  and  placed  aside  in  a  vessel.  What  is  left  in 
the  interrupter  should  be  poured  into  an  iron  bowl,  ami  tlie  resi- 
due of  alcohol  ignited.  When  the  alcohol  has  burnt  away  clean 
mercury  is  left  lying  on  a  layer  of  muddy  debris.  The  mercury 
should  be  poured  oft  antl  the  mud  stirred  with  a  stick,  whereby 
the  rest  of  the  mercury  separates  and  is  ready  for  collecting. 
The  whole  process  should  be  completed  in  the  open  air  on 
account  of  the  poisonous  mercury  fumes  evolved.  Do  not  neg- 
lect after  this  operation,  or  after  iiuich  handling  ot   the  leaden 


228 


RADIO-THERAPY 


masks  (see  later) ,  to  always  wash  the  hands  with  soap  and  water 
so  as  to  avoid  lead  or  mercury  poisoning. 

It  is  advisable  to  remove  the  electrodes  from  the  acid  when 
an  electrolytic  interrupter  is  not  in  use. 

Vacuum-tubes  must  be  kept  in  a  dry  place,  free  from  shocks 


Fig.  74. 


or  risk  of  violent  shaking.     The  best  plan  is  to  line  the  box  in 
which  they  are  kept  with  wood-wool  or  cotton-wool. 

The  following  articles  are  necessary  auxiliaries  for  Roent- 
gen-therapy : 

1.  A  tube-stand,  either  fixed  to  the  wall  or  movable,  and 
preferably  with  two  arms,  so  that  two  tubes  may  be  connected 
If  desired  (Fig  74  rt). 

2.  An  operating-chair  with  adjustable  head-rest    {d) . 


TREATMENT  fVITll  X-RAYS  229 

3.  A  small  table  with  an  adjustable  top  {b) . 

4.  A  clock  for  timing  the  sittings. 

5.  A  couch. 

6.  A  fluorescent  screen,  for  examining  the  quality  of  the 
tubes  (c,  Fig.  74) .  If  the  room  cannot  be  darkened,  this  screen 
must  be  fixed  in  a  darkened  box. 

7.  Sev^eral  leaden  plates  I  cm.  thick,  thick  cardboard, 
tapes,  pasteboard  masks,  lead-fuses,  and  a  variety  of  mechanical 
tools,  such  as  pliers,  files,  screw-drivers,  etc. 


§  29.   The   Development  of  the   Therapeutic   Employment 
of  Roentgen-rays.') 

Roentgen-therapy  has  already  undergone  considerable  de- 
velopment and  has  received  definite  indications  for  its  employ- 
ment and  method,  whereas  the  theoretical  investigations  of  the 
detailed  physiological  effects  of  the  process  has  only  recently 
been  commenced,  and  this  with  comparatively  small  success. 
Consideration  of  this  circumstance  induces  the  author  to  place 
the  chapter  on  Roentgen-therapy  before  that  on  Roentgen-physi- 
ology. Many  facts,  moreover,  to  be  found  in  this  section  are  of 
significance  in  a  physiological  sense,  and  will  not  require  repe- 
tition later,  but  merely  a  reference  to  the  present  chapter. 

The  origin  and  development  of  the  Roentgen-therapy  of  skin 
diseases  dates  from  an  experiment  made  by  the  author  in  1896 
with  the  object  of  removing  the  hair  from  a  large  nasvus  pig- 
mentosus  pilosus  in  a  girl.  This  experiment  was  prompted  by 
a  newspaper  article  in  June,  1896,  in  which  it  was  reported  that 
a  man  working  with  X-rays  became  afflicted  with  a  dermatitis 
accompanied  by  extensive  loss  of  hair  from  the  head;  further 
by  an  article  appearing  soon  after  that  in  No.  30  of  the 
"Deutsch.  Med.  Wochenschr.,"  from  the  pen  of  Dr.  PV.  Mar- 
cuse  of  Berlin,  who  noticed  the  same  effects  after  a  fortnight's 
radiation  on  the  head  of  a  young  man. 


')   A  lucid  ncconnt  of  Roentgen  llierapy  is  given  in  the  cxrollont  article 
by  Ilcrr  frof.  /\',»/-//  in  ilic  Han(II>iuIi  dcr  physik.  Thcrapie  TIi.   II.  P.d.   i. 


230  RADIO-THERAPY 

The    author   made    the    following   arrangements    for   this 
experiment  ^ )  : 

A  Ruhmkorfs  coil  by  Reiser  and  Schmidt  of  Berlin, 
having  a  25  cm.  spark-length,  was  worked  from  accumu- 
lators, and  vacuum-tubes  which  had  been  proved  to  be 
rich  in  X-ray  powers  were  used.    The  tubes  were  capable 
of  giving  a  Roentgen  photograph  of  a  man's  hand  at  a 
distance  of  15  cm.  with  one  minute's  exposure,  and  the 
fluorescent  screen  was  used  from  time  to  time  to  prove 
their  proper  working.     These  tubes  possessed  platinum 
anti-cathodes  and  aluminium  electrodes,  and  the  most 
serviceable  of  all  were  found  to  be  those  of  Messrs. 
Frister  of  Berlin.     Ordinary  Hittorfs  tubes  were  only 
used  in  those  experiments  where  it  was  desired  to  ex- 
clude the  cathode-rays  as  far  as  possible.   The  child  was 
made  to  sit  with  its  back  bared,  and  the  tube  was  placed 
at  a  distance  of  10  cm.,  so  that  the  zone  richest  in  X-rays 
coincided  with  the  nape  of  the  neck.    In  this  way  a  large 
part  of  the  na^vus  from  the  scalp  down  to  about  the 
middle  of  the  dorsal  spine  was  irradiated.     At  first  a 
thick  leaden  mask  with  an  aperture  corresponding  to 
the  area  of  the  naevus  was  used;  this,  however,  was  soon 
dispensed  with,  the  result  of  the  experiment  being  ap- 
parently so   doubtful.     The   exposure  was  two  hours 
daily. 

The  author  soon  convinced  himself  that  no  percep- 
tible heat  was  evolved  from  the  tube.  The  child,  though 
a  sensitive  one,  endured  the  sittings  extremely  well 
and  remained  well  and  lively  throughout.  For  the 
first  ten  days  no  change  whatever  occurred;  not  a 
single  hair  fell.  On  the  eleventh  day  (December 
3rd,  1896)  the  mother  removed  several  bundles 
of  loose  hairs  from  the  inter-scapular  region,  and  the 

')  Wiener  med.  Wochenschr.,  1897,  No.  10.  The  assertion  made  repeat- 
edly in  the  latter  by  Prof.  Dr.  E.  Schiff  to  the  effect  that  the  author  made  these 
experiments  under  his  (Schiff's)  control  is  not  borne  out  by  facts.  They 
were  carried  out  independently  by  the  author  in  the  K.  K.  graphisch.  Lehr- 
und  Versuchsanstalt  in  Vienna;  Herr  Hofrath  Director  Dr.  7.  M.  Edcr 
alone  assisted  him  with  his  advice  in  the  purely  physical  questions. 


TREATMENT  WITH  X-RAYS  231 

author  did  likewise.  With  gentle  pulling,  bundles  of 
5-10  hairs  came  out  each  time  in  one's  lingers,  with  abso- 
lutely no  sensation  of  pain  on  the  part  of  the  child. 
The  individual  hairs  were  thin,  showing  no  bulbar  en- 
largement at  the  root  to  the  naked  eye.  A  microscopic 
examination  by  Dr.  Ad.  Zcmaun  showed  atrophy  at  the 
roots.  The  skin  in  this  region  was  quite  smooth  and 
showed  neither  reddening  nor  any  other  change.  The 
shedding  of  hair  continued  steadily  in  the  nape  of  the 
neck  (although  for  reasons  which  will  appear  later  the 
irradiation  was  discontinued  in  this  region),  and  by  the 
8th  of  December  there  was  an  actual  alopecia  involving 
the  lower  part  of  the  back  of  the  head.  From  the  loth 
December  the  shedding  of  hair  decreased  in  amount 
somewhat,  though  persisting  for  some  time  in  lesser  de- 
gree. On  the  iith  December,  that  is,  eight  days  after 
the  commencement  of  the  hair-shedding,  a  dermatitis 
developed  from  two  small  excoriations  which  had 
already  been  noted  on  the  nape.  This  consisted  of  a 
diffuse  reddening,  with  here  and  there  several  small 
moist  excoriations  varying  from  the  size  of  a  lentil  to 
that  of  a  sixpence.  This  dermatitis  disappeared  after  a 
few  days'  treatment  with  ichthyol  ointment,  and  with  it 
w^ent  the  few  remaining  hairs  at  the  nape.  The  back  of 
the  head  and  the  neck  and  the  upper  inter-scapular 
region  was  then  quite  denuded  of  hair,  and  only  a  slight 
reddening  left  by  the  dermatitis  was  to  be  seen  at  the 
nape  of  the  neck.  It  must  be  noted  that  a  large  portion 
of  the  bald  surface  had  never  shown  the  least  signs  of 
dermatitis. 

On  the  tenth  day  the  commutator  of  the  coil  was, 
through  an  oversight,  so  arranged  that  for  i  5-20  min- 
utes no  cathode-rays  were  evolved  from  the  tube.  When 
on  the  eleventh  day  the  hairs  began  to  fall  it  was  thought 
possible  that  this  result  was  due  to  "anode-rays."  ')  To 
verify  this  the  experiment  was  changed.    The  n;rvus  on 


')   Three   years    later    O.    Berg    cxpcrimcnlally    proved    the   existence    of 
anode-rays.     (See  page  191.) 


232  RADIO-THERAPY 

the  right  arm,  which  was  at  some  distance  from  the 
previously  exposed  region,  was  exposed  for  twelve  days 
to  a  "reversed"  tube.    The  results  were  negative. 

The  task  still  remained  to  exclude  any  possible  ef- 
fects from  electric  currents  in  the  shape  of  spark  dis- 
charges from  the  tube  to  the  skin.  With  this  object  in 
view,  the  lowest  part  of  the  nasvus  was  exposed  to  the 
X-rays,  but  between  the  tube  and  the  skin  a  sheet  of  thin 
cardboard  covered  with  aluminium-foil  was  interposed. 
The  aluminium,  which  is  very  transparent  to  the  rays, 
was  suitably  "earthed."  This  screen,  therefore,  while 
allowing  X-rays  to  penetrate  freely,  acted  as  a  dis- 
charger for  the  electricity.  The  experiment  was  begun 
on  December  i8th,  1896,  and  eight  days  later  the  hair 
on  the  irradiated  area  began  to  fall.  Till  the  2nd  Jan- 
uary this  shedding  of  hair  was  only  small  in  amount, 
being  about  5  or  6  hairs  daily. 

After  that  it  increased  to  5-10  hairs  daily.  On 
January  5th  slight  erythema  was  noticeable,  and  by 
then  the  hair  had  almost  disappeared  from  the  middle 
of  the  field.  Altogether  this  region  was  exposed  for 
42  hours. 

These  three  experiments  clearly  showed  that  the 
cause  of  the  phenomena  above-mentioned  was  to  he 
found  in  the  Roentgen-rays.  Neither  the  anode-rays  nor 
the  high-tension  electric  waves  could  have  produced  the 
effects.  Moreover,  in  the  second  series  of  experiments, 
sparks  were  often  seen  to  jump  from  the  tube  to  the 
arm  to  which  it  was  adjacent,  and  again  the  hairs 
bristled  up  towards  the  tube  (both  events  showing  that 
electricity  was  passing  from  tube  to  skin),  but  no  loss 
of  hair  resulted. 

Another  point  brought  out  by  these  experiments  was 
that  the  comparatively  thin  and  long  hair  of  the  scalp 
fell  out  more  readily  than  the  strong  short  liairs  of  the 
ncevus;  in  the  latter  situation  again  it  was  found  that 
the  fine  lanugo-hairs  fell  more  freely,  and  after  a 
shorter  exposure  than  the  stouter  hairs. 


TREATMENT  JVITH  X-RAYS  233 

Firiiilly,  it  became  evident  tJiat  llie  X-niys  only  pro- 
duce their  effect  after  a  long  exposure  (  1 1  to  22  lioiirs), 
but  t licit  this  effect  is  maintained  for  some  time  {S  to  12 
days)  afterzvards;  the  rays  have  therefore  a  cumulative 
action. 

Was  the  falling  of  the  hair  due  to  the  dermatitis 
alone,  being  analogous  to  the  well-known  alopecia  symp- 
tomatica seen  after  erysipelas  and  eczema?  Probably 
not,  bearing  in  mind  the  late  appearance  of  the  derma- 
titis (seven  days  after  the  first  falling  of  hair)  and  its 
slight  character.  The  author  published  the  facts  con- 
cerning the  later  condition  of  the  child's  skin,  and  the 
conclusions  to  be  drawn  from  the  whole  history  of  the 
case,  in  the  Wiener  Med.  Wochenschrift,  1897,  No. 
19.  From  this  article  it  may  be  learned  that  the  nape 
of  the  neck  showed  no  change  till  F'ebruary  22nd,  when 
a  little  fine  down  was  to  be  seen  on  the  occiput.  These 
new  hairs  were  confined  to  the  scalp  region  at  first,  the 
nape  of  the  neck  remaining  quite  bare  till  March  14th, 
when  fresh  hair  grew  here  also.  In  the  dorsal  region 
the  changes  were  very  surprising.  This  part  had  been 
last  irradiated  on  January  15th,  1897,  the  total  ex- 
posure having  been  about  42  hours.  On  January  i8th 
the  erythema  here  became  more  intense  and  all  the  hair 
fell  out  at  the  same  time.  On  January  20th  and  the 
succeeding  days  the  erythematous  portion  of  the  skin 
showed  numerous  small  vesicles,  which  soon  burst. 
Next  the  epithelium  peeled  off,  leaving  a  large  raw  sur- 
face, which  was  bright  red,  hot  and  oozing  freely. 
After  a  few  days  the  inflammation  became  less  acute. 
By  February  6th  a  whiter  patch  the  size  of  a  child's 
hand  was  to  be  seen  within  the  bright-red  granulating 
excoriation  in  the  region  of  the  9th  dorsal  vertebra, 
and  from  this  similar  streaks  ratiiatcd  on  to  the  neigh- 
bouring surface.  On  this  part  the  central  rays  of  the 
light-cone  had  fallen.  The  base  of  the  excoriation  ap- 
peared deepened,  and  at  the  lower  border  one  could 
see  two  round  epithelial  islands.     It  seems  remarkable 


234  RADIO-THERAPY 

that  in  spite  of  the  appearances  above  mentioned  the 
child  had  no  special  pain.  Ihe  chief  thing  complained 
of  was  itching  round  the  borders  of  the  excoriation, 
where  some  eczema  had  resulted  from  the  irritating  dis- 
charge. The  temperature  and  urine  were  normal !  In- 
stead of  the  applications  of  liquor  burowii  cooled  in  ice, 
which  had  hitherto  been  used,  dressings  of  ointment 
were  now  prescribed  (Ung.  paraffin,  ung.  boracic,  etc.), 
and  later  on  baths,  but  none  of  these  influenced  the  der- 
matitis in  any  way.  Bad  nursing  may  also  have  con- 
tributed to  the  want  of  success,  since  various  household 
nostrums  were  used  without  the  author's  knowledge  at 
that  time. 

Towards  the  end  of  February  the  child's  general 
health  began  to  suffer.  She  was  obliged  to  stay  in  bed 
altogether,  became  pale,  lost  her  appetite  and  slept 
badly.  There  was  now  much  pain  in  the  raw  places. 
This  pain  came  on  often  in  paroxysms,  especially  during 
the  night,  and  the  attacks,  lasting  some  fifteen  minutes, 
were  localised  to  the  sides  of  the  chest  and  abdomen. 
From  what  the  child  said,  the  pains  appeared  to  shoot 
obliquely  downwards  towards  the  bladder.  There  was 
no  sensitiveness  on  pressure  anywhere.  The  attacks  of 
pain,  which  were  so  severe  that  they  always  left  the 
child  bathed  in  perspiration,  always  came  to  an  abrupt 
termination  and  were  followed  usually  by  micturition. 
Examination  of  the  urine  showed  an  acid  reaction,  some 
albumen,  and  deposits  of  urates,  but  otherwise  nothing 
abnormal.  By  the  loth  of  March  the  white  patch 
above  mentioned  became  more  prominent,  while  the 
surrounding  excoriation  became  duller  and  of  a  pale  red- 
dish-yellow colour.  The  base  of  the  ulceration  was 
considerably  deeper  and  a  delicate  red  flush  could  be 
seen  on  its  (Edematous  borders.  The  ulceration  proceded 
apace;  soon  the  entire  inflamed  region  was  trans- 
formed into  a  large  ulcer,  whose  uneven  base  was 
covered  with  dark-brown  putrid  shreds  of  tissue.  The 
child  had  now  a  high  fever  and  was  quite  prostrate. 


TREATMENT  JVITH  X-RAYS  235 

while  the  urine  showed  an  abundance  of  albumen.  With 
sublimate-gauze  dressings  and  baths  the  patient  rallied 
somewhat  and  was  taken  to  the  dermatological  clinic. 
Here  the  improvement  became  marked  in  a  few  days 
and  the  ulcers  showed  signs  of  healing.  The  parents 
unfortunately  withdrew  the  child  from  the  hospital 
on  March  29th,  Further  progress  of  the  case  was 
marked  by  granulation  and  closing  in  of  the  wound. 
By  May,  1901,  the  wound  was  closed  by  a  somewhat 
hypertrophic  scar  with  the  exception  of  a  patch  the  size 
of  a  florin,  which  also  was  slowly  healing.  The  scar 
next  unfortunately  gave  way  as  the  result  of  injury, 
necessitating  further  surgical  aid.  The  following  con- 
clusion was  drawn  from  the  progress  of  the  case  as 
above  described.  In  the  flrst  place,  the  unexpected 
appearance  of  the  ulceration  gave  signal  warning  that 
caution  was  to  be  observed  in  experimenting  with 
X-rays.  It  was  evident  that  irradiation  too  long^  con- 
tinued might  produce  disagreeable  and  eveti  dangerous 
results.  It  appeared  that  not  only  the  total  length  of 
exposure,  but  the  time  of  the  individual  exposures  had 
to  be  considered.  On  the  other  hand,  shorter  total  ex- 
posures {20  hours  or  less)  suffice  for  the  therapeutic 
effect  of  epilation  without  causing  real  damage  to  the 
tissues  or  the  organism.  The  cumulative  effect  of  the 
X-rays  constitutes  the  chief  difficulty  to  be  contended 
with  in  determining  the  proper  period  of  exposure. 

It  will  be  noted  that  in  the  case  just  described,  the 
really  harmful  effects  took  two  months  to  develop.  In 
other  cases  (when  the  X-rays  were  used  with  a  dif- 
ferent object  in  view)  the  author  has  seen  the  hair  fall 
after  a  much  shorter  exposure.  Other  factors  beside 
the  time  of  exposure  have  to  be  considered,  viz :  the 
intensity  of  the  irradiation  and  the  distance  of  the  tube 
from  the  skin. 

Since,  as  the  first  series  of  experiments  showed,  it 
was  possible  to  obtain  complete  epilation  effects  lasting 
two  months  and  a  half,  while  avoiding  any  disagreeable 


236  RADIO-THERAPY 

after-effects,  //  appeared  that  Roentgen-rays  might  rea- 
sonably be  used  experimentally  for  the  removal  of  hairs 
provided  the  warnitigs  above  mentioned  were  obeyed; 
apart  from  the  fact  that  the  efect  was  maintained  for 
a  considerable  period,  the  brevity  and  painlessness  of 
the  treatment  as  compared  with  the  other  methods  of 
dealing  with  hypertrichosis  were  a  further  inducement 
in  this  direction.    Moreover,  it  seemed  likely  that  re- 
sults might  be  made  permanent,  if,  acting  upon  Kaposi's 
theory,  one  endeavoured  to  maintain  the  paretic  condi- 
tion  of  the   papillary  vessels.     This   might  be  accom- 
plished by  giving  short  exposures   throughout  a  long 
period.     Inasmuch  as  a  nerve  which  is  paralysed  for 
some  time  often  never  recovers  its  function,  it  might  be 
possible  to  so  influence  the  vaso-motor  nerves  in  this 
way  that  they  would  lose  their  power  of  providing  for 
the    nutrition    of   the    hair    follicles;    in    this   way   the 
existence  of  the  hair  itself  would  become  impossible. 
Moreover,  the  epilatory  powers  of  the  X-rays  might  be 
turned  to  account  in  other  skin  affections,  such  as  syco- 
sis and  favus,  where  a  temporary  epilation  is  of  great 
advantage.     Experiment    only    was    wanted    to    verify 
these  hypotheses. 
The  data  obtained  from  the  above-mentioned  experiments, 
giving  promise  of  a  rational  therapeutic  employment  of  X-rays, 
induced  the  author  to  pursue  his  investigations  in  spite  of  warn- 
ings from  an  authoritative  source  (Kaposi).    A  definite  action 
of  the  rays  on  the  skin  had  been  experimentally  proved,  and 
this  was  sufficient  for  its  judicious  employment  in  the  treatment 
of  skin-disease. 

It  seemed  somewhat  tempting  to  experiment  with  an  agent 
which  evidently  had  such  an  extraordinary  influence  on  the  cu- 
ticle and  which,  according  to  later  reports,  had  a  favourable 
effect  on  the  inoculation-tuberculosis  of  animals,  as  a  means  of 
dealing  with  local  tuberculosis  of  the  skin  (lupus  vulgaris). 
As  a  matter  of  fact  X-ray  therapy  soon  proved  that  in  this 
affection  very  good  results  could  be  obtained,  both  as  regards 
radical  cure  and  cosmetic  effect.     The  first  report  bearing  on 


TREATMENT  JVITH  X-RAYS  237 

this  question  was  made  by  Kiimmel  at  the  Congress  of  the 
Deutsche  chirurgische  Gesellschaft,  Easter,  1897.  At  the  same 
time,  and  independently  of  Kiimmel,  the  author  and  E.  Scliiff 
(to  whom  the  publication  of  these  experiments  was  left')) 
treated  and  cured  two  cases  of  lupus  vulgaris  by  means  of 
X-rays.  Soon  after  this,  reports  followed  in  quick  succession  of 
favourable  results  in  various  kinds  of  skin  disease  treated  in 
tliis  way. 

Thus  Hahn  -)  first  employed  the  method  in  dealing  with 
chronic  eczema,  Sc/iiff '')  used  it  for  lupus  erythematosus,  the 
author  *)  for  sycosis  and  fa\'us,  Ehrmann  ■')  for  dermatitis  pap- 
illaris, Zimnssoi  '')  for  psoriasis,  Sort'l ' )  for  elephantiasis, 
Pokitonoff  -)  for  acne  vulgaris,  Jutcissy')  for  na?vus  flam- 
meus,  Kioibock  and  Holzknecht  ^")  for  alopecia  areata, 
Scholtz'^^)  for  lepra  and  mycosis  fungoides,  Sjiiirrcn  and  S ten- 
beck^'-)  for  epithelioma. 

At  the  present  time  all  those  ciiseases  are  regarded  as  suit- 
able for  this  treatment  in  which  a  temporary  or  permanent  re- 
moval of  hair  is  indicated  (such  as  hypertrichosis,  sycosis, 
favus)  ;  most  writers,  too,  speak  fa\ourably  of  its  employment 
in  lupus  vulgaris  and  epithelioma.  In  the  case  of  other  skin 
affections  opinions  are  more  divided,  which  is  only  to  be 
expected  considering  the  comparatively  recent  introduction  of 
X-ray  therapy.  In  many  quarters  the  view  was  and  still  is  held 
that  good  therapeutic  effects  are  only  to  be  obtained  by  first 
exciting  powerful  reactions.     Many  operators,  indeed,  make  it 


')  Archiv.  f.  Dcrmatologic  und  Syi)liilis,  Bel.  XLII.  i.   FIcft. 

^)  Fortsclir.  auf.  d.  Geljietc  der  RociUgcnslr..  Bd.  II,  llcft   i. 

')  Ibid.  Bd.  II,  Heft  4. 

*)  Wiener  dermatolog.  Gesell.-cliafl,   May  10,   i8gg. 

")  Wr.  Med.  Wnchenschr.,  iqoi,  Nr.  .30.  ,31. 

•)  Aerztl.  Verein  Miinchen,  8  June.  1898,  and  Congress  f.  innere  .Medicin, 
Wiesbaden,  1898. 

^)  La  Normandie  .Mcdicale,  I'chruary,  1898. 

*)  XII  Intern,  med.  Congr.  Moscow,  1897,  Dermatological   Section. 

*)  Fortschr.  auf  d.  Gebicte  d.  Rontgcnstr..  Bd.  II,  TIcft  (^. 

")  K.  K.  Gesellsch.  d.  Aerzte,  2  Nov..  1900.  and  Wr.  klin.  Rundschau, 
1901,  No.  41. 

")  Arch.   f.   Dermatologic  und  .Sypliilis    I'.d.    1.1. \,    llcfl  3. 

")  XII  f.   iiittrnat.   nicij.   Congress.    I'ari>,    1900. 


238 


RADIO-THERAPY 


their  first  aim  to  arouse  violent  inflammations.  Under  these 
circumstances  it  is  not  to  be  wondered  at  that  more  prudent  men 
{Riehl,  for  example) ,  who  saw  some  of  the  results  of  this  heroic 
school,  looked  askance  at  the  whole  method. 

A  report,  howev^er,  submitted  by  the  author  to  the  Xllth 
International  Congress  held  in  Moscow,  showed  conclusively 
that  under  proper  conditions  the  treatment  could  give  the  best 
results  and  yet  be  free  from  these  untoward  accompaniments. 

In  view  of  some  of  the  facts  noted  in  the  table  below  it  can 
be  seen  that  epilation  is  quite  possible  without  disastrous  effects 
accompanying  the  process.  The  first  experiment  undertaken  by 
the  author  proved  conclusively  that  the  cause  of  the  Roentgen- 
dermatitis  lay  in  too  intense  an  irradiation. 


Observer 

and 

Publication 

Dis- 
tance of 
Tubes 

Duration  of 
Exposure 

Part 
Exposed 

Physiological  Effect 

Remarks 

Si/ir7uald, 

14  cm. 

45  minutes: 

Abdomen: 

After  14  days  slight 



Deutsche  med. 

one  exposure 

boy,    134 

dermatitis  and  pig- 

Wochenschr., 

years  old" 

mentation.   Falling 

1896,  No.  42 

of  lanugo-hair,  lit- 
tle sweat  secretion 

Marcuse, 

25  cm. 

Once   or  twice 

Face  and 

In  one  place  derma- 

Hair grew 

Deutsche  med. 

daily    (5 — 10 

scalp 

titis,     in     another 

again 

Wochenschr., 

m  i  n  . )    for    4 

alopecia ;  the  latter 

after 

1896,  No.  30 

weeks 

not  inflamed 

3  months 

Conrad, 

— 

A  repeated  long 

— 

The   moustache 

— 

Codex  Medic, 

exposure   for 

fell,    and    changed 

Aug.,  189(3 

photographic 
purposes 

its  colour 

Maciniyre, 

— 

Worked     for 

Hand 

Loss  of  hair 

— 

Nature,  1896, 

months     with 

No.  1412, 

X-rays 

Vol.  55. 

19th  Nov. 

E.  E.  King, 

— 

Worked    for 

— 

After    5   weeks  loss 

— 

Canadian  Prac- 

2\    m  0  n  t  h  s 

of  hair   (eyebrows, 

titioner, 

daily  (2-6  hrs.) 

beard,    hand)   and 

Nov.,  1896 

with  X-rays 

nails 

Kollc, 



Once  40  min. 

Head 

Alopecia   after    16 

Hair  grew 

Broolvlyn  Med. 

days ;  no  dermatitis 

again 

Journal,  1896, 

later 

X,  12 

/.  Daniel, 

i| 

Once  I  hour 

Head 

Alopecia  after    21 

— 

Med.  Record, 

inches 

days;  no  dermatitis 

1896, 

Vol.  49,  17 

TREATMENT  JVITH  X-RAYS 


239 


Observer 

and 

Publication 


Dis- 
tance of 
Tubes 


Duration  of 
Exposure 


Part 
Expiised 


Physiological  EfTect 


Remarks 


University  of 

Minnesota, 
Med.  Record, 

1896,  Vol.  50, 
No.  25 

W.  B. 

Banister, 

Med.  Record, 

1897,  Vol.  52, 
No.  4 

Broca, 

Stances  de  Soc. 

fr.  d.  Phys., 

iSthDec'iSgb 

Paul  Richer 

and 
Albert  Londe 


Forstcr, 

Deutsche  med. 

Wochenschr., 

1897,  No.  5 


Idem. 


J.  Mies, 

Deutsche  med. 

Wochenschr., 

1897,  No.  26 


/.   [iitassy 

Orvcisi  Hetilap, 

1897,  XLI., 

24-25 

Fovcaii  de 

Cotirmcllcs, 

Soc.  de  Biolog., 

17th  July,  1897 

Freiind, 

Wr.  Medic. 

Wochenschr., 

1897,  No.  10 

Idem. 


S-io 
cm. 


About 

10-40 

cm. 


15  cm. 


15  cm. 


For  a  consider- 
able period 


Numerous    ex- 
posures 


Worked  for 
2-3  months 
daily  for  sev- 
eral hours 
with  X-rays 

Twice  25  min. 
each  time 


Once  15  min., 
after  7  days 
30  min.  again 

For  16  days 
twice  10  min. 
daily 


Seven  sittings 
of  2  hours 
each 


12    days    for 
hours  each 


hours 


Ear  and 
scalp 


Abdomen, 
chest  and 
neck 


Hand 


Head  of  a 
man  at  30 


Head  of  a 
man  at  40 


Cheek  of  a 
girl  of  23 


Face,  neck, 
chest, of  a 
girl 


Skin  as  if  frozen ; 
the  hair  had  fallen 
out;  no  subjective 
symptoms 

Well-marked  der- 
matitis; the  beard 
became  grey  a  n  d 
fell  out  in  parts 

Long  after  the  ir- 
radiation the  skin 
and  hair  fell  off 

Dermatitis,  falling 
of  the  fine  hairs, 
alteration  of  the 
nails 

After  6  days  alo- 
pecia, pigmenta- 
tion of  the  h  a  i  r  - 
roots,  disturbed 
sensation  of  the 
temperature  ;  ;/  0 
dermatitis 

After  3  days  alo- 
pecia, no  dermatitis 


On  the  i6th  day  der- 
matitis, and  a  1  o- 
pecia;  at  the  bare 
place  no  dermati- 
tis: disturbed  sen- 
sibility 

At  the  places  near 
the  tube  derma- 
titis; at  those  very 
far  from  it  alopecia, 
without  dermatitis 

Alopecia,  ivithout 
inflammation 


Back    of  Alopecia  ; 
the    head 


of 
of 


girl 


Hack  of 
the  same 
individ- 
ual 


at  t  h  e 
nape  of  the  neck 
sligiit  dermatitis; 
at  the  occiput  no 
dermatitis 
Alopecia  ;  well- 
marked  dermatitis 


For  more 
than  3  mos. 
no  after- 
growth of 
hair 


After  81 
days  the 
hair  start- 
ed growing 
again 


240  RADIO-THERAPY 

In  a  later  communication  \)  the  author,  in  conjunction  with 
Schiff,  explained  how  satisfactory  results  had  been  safely  ob- 
tained in  a  series  of  cases. 

The  treatment  is  controlled  by : 

1.  Increasing  or  diminishing  the  output  of  X-rays. 

2.  The  mode  of  administration  of  the  same. 
As  factors  of  importance  In  ( i )  we  may  note: 

(a)  The  quality  of  the  coil,  Interrupter  and  vacuum- 
tube. 

(b)  The  electro-motive  force  and  current  strength 
employed. 

With  regard  to  (2)  the  following  are  of  Impor- 
tance : 

(d)  The  distance  of  the  tube  from  the  object;  (b) 
the  duration  of  the  individual  exposures. 

In  order  to  ascertain  in  the  first  place  whether  the, 
patient  possesses  an  Idiosyncrasy  in  the  shape  of  special 
susceptibility  to  X-rays  (which  happens  now  and  then, 
according  to  some  writers)  trial  exposures  are  given, 
as  suggested  by  the  author.  These  consist  of  one  or 
two  sittings  of  15  minutes  each  at  a  distance  of  20  cm., 
the  rays  being  of  medium  strength;  other  authorities 
state  this  to  be  the  smallest  "dose"  capable  of  causing 
dermatitis.  The  patient  is  then  watched  for  three 
weeks.  In  the  event  of  any  evident  reaction  being 
noticeable  in  that  time  (though  the  authors  never  saw 
this  happen)  some  modification  In  the  exposure  is  called 
for.  Patients  who  are  undergoing  treatment  for  hyper- 
trichosis are  warned  against  pulling  out  the  hair  (a  pre- 
vailing habit  with  these  people)  so  that  the  extent  to 
which  the  exposure  should  be  pushed  may  be  gauged. 

The  Intensity  and  quality  of  the  rays  emitted  from 
a  given  tube  appear  to  depend  only  upon  Its  state  of 
vacuum  and  the  character  of  the  primary  current,  etc., 
but  also  upon  certain  inherent  properties  of  the  tube 
which  up  to  the  present  time  are  Imperfectly  understood. 


*)  Wiener  med.  Wochenschr.,  1898,  Nos.  22-24. 


TREATMENT  IIITH  X-RJYS  241 

The  fluorescent-screen  must  consequently  be  employed 
as  a  means  of  estimating  the  intensity  of  the  rays  in  a 
given  Instance. 

The  course  of  events  in  the  two  lupus  cases  men- 
tioned above  was  as  follows  ^ )  : 

After  a  time  the  lupus  nodules  became  dark-red 
and  turgid;  moreover,  small  foci  of  disease  became  vis- 
ible In  parts  which  hitherto  had  appeared  healthy. 
Later  on  the  nodules  disappeared,  leaving  sharp-cut 
ulcers  the  size  of  a  pin's  head.  The  final  result  was 
as  follows:  The  site  of  the  nodules  became  occupied  by 
reddish  depressed  scars,  the  surrounding  skin  being 
smooth  and  white. 

Where  the  method  was  employed  for  the  removal  of 
hairs  the  best  therapeutic  effect  was  obtained  by  expos- 
ing for  17-30  short  sittings.  Beyond  an  occasional 
slight  erythema  no  inconvenience  was  felt  by  the 
patients.  In  several  cases  pigmentation  was  noted  one  or 
two  days  before  the  hair  began  to  fall.  This  pigmenta- 
tion increased  for  the  next  day  or  two,  afterwards  dis- 
appearing rapidly  within  three  or  four  days.  A  remark- 
able effect  was  seen  in  the  case  of  several  brunettes 
who  were  under  treatment,  the  hair  before  It  fell  out 
becoming  snow-white.  In  one  case  the  pigmentary 
change  was  repeated  on  exposing  the  second  and  third 
crop  of  hair  after  the  Initial  removal.  Another  note- 
worthy effect  was  seen  In  skins  disfigured  by  folliculitis 
and  scars  (often  the  result  of  electrolysis).  These 
became  comparatively  smooth  after  the  treatment. 

In  all  these  cases  the  cumulative  effects  of  X-rays 
to  which  Frennd  and  later  Forslcr  and  others  had  called 
attention,  were  well  seen. 

In  the  same  communication  arguments  were  given  In 
favour  of  Freund's  assumption  that  the  physiological 
effects  of  irradiation  are  due  rather  to  X-rays  than  to 
electrical  discharges.     It  was  noted,   for  Instance,  that 


*)   This  was  outlined  l)y  Scliiff  in  tlu-  puhlicrition  already  mentioned. 


242  RADIO-THERAPY 

the  epilated  surface  was  always  circular,  the  circle  being 
larger  when  the  tube  was  farther  from  the  skin.     This 
could  be  at  once  understood,  bearing  in  mind  the  cone- 
shaped  field  of  the  X-rays  as  emitted  from  the  anti- 
cathode.     The  leaden  masks  again  completely  confined 
the  physiological  effects  to  the  area  of  skin  exposed  to 
X-rays,  while  they  did  not  altogether  protect  the  skin 
underlying  them  from  spark  discharges.     If,  indeed,  the 
electric  discharge  were  the  causal   factor,  why  should 
physiological  effects  be  first  manifested  in  the  deeper 
layers  of  the  skin,  to  be  followed  later  by  surface  phe- 
nomena ?     For  in  most  cases  the  falling  of  the  hair  pre- 
ceded the   erythema.      Finally   tubes   of   high   vacuum 
requiring  powerful  currents  for  their  working  produced 
slighter  physiological  effects  than  softer  tubes  working 
with  much  feebler  currents. 
The  writings  of  Kienbock,^)  Strdtter')  and  Scholtz^)  are 
of    importance    in    the    history    of    Roentgen-therapy.      These 
authors  insisted  on  the  necessity  of  giving  due  consideration  to 
the  state  of  vacuum  of  the  tubes  employed,  pointing  out  that 
"soft"  tubes  were  more  effective  than  "hard  ones."  This  fact  had 
already  been  referred  to  by  the  author  in  1897,  at  the  Interna- 
tional  Medical  Congress  in   Moscow;  also  in  the  work  with 
Schijf  above  mentioned.    Those  works  of  Kienbock  and  the  rest 
proved,   moreover,   that  the  author's  original  view,   ascribing 
therapeutic    results    to    X-rays    rather    than    to    electrical    dis- 
charges, was  correct.     For  the  author  had  been  in  the  mean- 
time led  somewhat  too  far  by  experiments  with  spark-discharges 
alone,  which  gave  results  very  similar  to  those  of  X-rays  and 
led  him  to  somewhat  underestimate  the  value  of  the  latter. 

It  will  be  noted  that  a  knowledge  of  the  fact  that  different 
tubes  possess  different  actinic  effects,  according  to  their  state  of 
vacuum,  is  of  the  greatest  importance  also  in  avoiding  excessive 
reaction. 

In  the  earlier  stages  of  the  history  of  Roentgen-therapy 


')   Wiener  Klin.  Wochenschr.,  igco,  No.  50. 

')  Deutsche  med.  Wochenschr.,  1900. 

")  Archiv.  f.  Derniat.  u.  Syph.,  Bd.  LIX,  H.  3. 


TREATMENT  UlTH  X-RJYS  243 

efforts  were  chiefly  made  to  widen  the  field  for  its  employment 
and  to  perfect  its  technique  rather  than  to  investigate  its  mode 
of  action.  The  last  two  years,  however,  have  seen  much  work, 
of  moment  in  the  latter  direction.  Not  only  has  the  question 
as  to  which  is  the  most  effective  agent  in  radio-therapy  been 
dealt  with  and  brought  nearer  to  a  solution,  but  writings  are  to 
be  recorded  on  histological  investigation  into  healthy  and  dis- 
eased tissues  which  have  been  under  treatment,  on  bacteriologi- 
cal investigations,  and  experiments  with  protozoa  and  other  low 
forms  of  life,  all  helping  to  a  better  understanding  of  the  bio- 
logical effect  of  Roentgen-radiation.  In  this  connection  refer- 
ence must  be  made  to  the  important  works  of  Gassman,^) 
Groircen,  Ehrmann, -)  Scholtz,')  Joseph  and  Provazek*)  and 
others. 

§  30.    Method   of  Treatment  with   X-Rays. 

The  main  factors  which  have  to  be  considered  in  X-ray 
therapy  are : 

1 .  The  strength  of  the  primary  current. 

2.  The  capacity  of  the  coil. 

3.  The  intensity  of  the  rays  and  the  state  of  vacuum  of  the 
tubes. 

4.  The  duration  and  frequency  of  the  sittings. 

5.  The  distance  of  the  tube  from  the  exposed  region. 

6.  The  susceptibility  of  the  tissue  exposed. 

In  the  first  place  it  is  essential  that  the  primary  current  be 
not  of  too  high  intensity.  It  must  be  remembered  that  Roent- 
gen-rays represent  a  condition  of  transformed  electrical  energy. 
1  he  greater  the  amount  of  electrical  energy  supplied,  therefore, 
the  more  powerful  will  be  the  output  of  the  rays;  moreover,  the 
electrical  discharges  from  the  tube  will  be  correspondingly  in- 
tensified. 

The  beginner  should  never  work  with  currents  above  i  .]-3 
amperes,  and  even  the  expert  should  employ  the  greatest  caution 


')  I'ortsclir.  anf  d.  Gcbiete  d.  Rocntgcnstr.,  Bd.  II,  H.  4. 

')  Wiener  mcd.  VVoch.,  1901,  Nos.  30.  31. 

»)  Arch.  f.  Dermat.  11.  Syph.,  Bd.  LIX.  H.  .1.  P-  424- 

*)  Zcit-chr.  f.  allg.   IMiyMologie,  Bd.   I,   II.  2,   1902. 


244  RADIO-THERAPY 

if  compelled  to  work  with  more  intense  currents,  say  up  to  6 
amperes. 

The  second  condition — the  capacity  of  the  coil — must  be 
considered  in  connection  with  the  preceding  one.  Currents  only 
should  be  chosen  which  give  but  short  spark-lengths  at  the  coil. 
If  only  a  large  coil  is  at  one's  disposal  it  should  never  be  worked 
at  its  full  capacity;  if  necessary,  resistances  should  be  used  with 
the  primary  current,  bringing  down  the  spark-length  at  the  coil 
to  15  cm.  Coils  whose  maximum  spark-length  capacity  is  30 
cm.  are  the  most  suitable  for  X-ray  therapy. 

As  has  been  mentioned  before,  soft  tubes  are  therapeutically 
more  effective  than  hard  ones,  other  things  being  equal.  If, 
however,  a  hard  tube  be  worked  with  a  more  powerful  current, 
It  may  give  as  rich  a  supply  of  X-rays  as  a  soft  tube  worked 
with  a  weaker  current. 

The  author  arrived  at  this  opinion  as  follows : 

An  elderly  neurotic  woman  had  been  treated  for 
hypertrichosis  intermittently  for  about  a  year,  using 
hard  tubes  and  a  Kohl's  coil  (30  cm.)  without  a  trace 
of  dermatitis,  the  hair  falling  regularly  after  21  to  30 
sittings.  The  patient  insisted  upon  the  treatment  being 
accelerated,  and  irradiation  was  then  combined  with  ap- 
plications of  uni-polar  discharges  from  the  coil.  '  After 
1 1  sittings  of  15  to  20  minutes  each,  a  somewhat  intense 
dermatitis  (without  ulceration)  arose,  which  it  required 
some  weeks  to  subdue.  Some  months  later  treat- 
ment was  resumed  of  the  skin,  which  still  remained 
hairy.  Two  or  three  brief  courses  of  treatment  with 
hard  tubes,  a  course  consisting  of  10  or  12  sittings  of 
15  minutes  each,  again  produced  temporarily  a  per- 
fectly smooth  skin  without  any  ill  effects.  The  patient, 
nevertheless,  clamoured  for  a  stronger  reaction,  having 
noticed  that  the  skin  remained  permanently  smooth  at 
the  site  of  the  former  Inflammation.  Only  one  other 
apparatus  was  at  the  disposal  of  the  operator,  and  this 
had  clearly  to  be  employed  with  great  caution  on 
account  of  the  high  Intensity  of  Its  secondary  currents. 
The  hardest  tube  was  therefore  used  with  this  appa- 


TREATMENT  iriTH  X-RAYS  245 

ratus,  a  brilliant  fluorescence  being  the  result.  Nine  sit- 
tings were  given,  each  lasting  7  to  10  minutes,  and  the 
result  was  a  violent  dermatitis  which  produced  an  ulcer 
the  size  of  a  kroner  piece. 

From  the  above  ^)  it  may  be  deduced  that  a  hard  tube 
which,  working  with  weaker  currents,  may  safely  produce  useful 
results,  gives  altogether  different  effects  if  worked  with  a  power- 
ful coil  and  stronger  currents. 

Nevertheless,  where  only  one  apparatus  is  available,  soft 
tubes  will  be  found  more  generally  useful  (worked  with  due 
precaution)  than  hard  ones. 

The  tubes  by  Gundclach  and  F.  Dessaiier,  and  IlirscJimann, 
in  which  the  vacuum  can  be  regulated,  have  already  been 
described  (p.  212-214). 

By  employing  3  sets  of  apparatus,  Beclcre'-)  professes  to 
be  able  to  produce  rays  which  penetrate  the  tissues  to  any 
required  depth.  The  instruments  used  are:  (i)  the  "ampoule 
a  osmo-regulateiir"  of  V'llhird,  which  is  said  to  prolong  the  life 
of  the  tube  indefinitely,  and  to  allow  one  to  control  its  penetrat- 
ing capacity;  (2)  Beclere's  "Spintemeter."  This  apparatus 
affords  indirect  evidence  of  the  penetrating  capacity  of  the  rays 
through  the  character  of  the  spark-discharge  at  the  terminals 
of  the  coil.  It  has  already  been  mentioned  that  this  sparking 
bears  direct  relation  to  the  resistance  offered  in  the  secondary 
circuit.  With  hard  tubes  the  spark  is  long,  being  short  with 
soft  tubes.  The  apparatus  is  nothing  more  than  the  graduated 
^spark-gap  which  has  been  supplied  for  many  years  by  certain 
German  manufacturers,  and  its  value  would  appear  to  be  only 
relative.  (3)  The  radiochromometer  of /ir;/o/5/.  This  Indicates 
the  strength  of  the  X-rays.  It  consists  of  a  thin  silver  plate 
having  a  broad  aluminium  border.   The  latter  Is  divided  into  12 


')  Apropos  of  hard  lubes  llic  following  case  may  be  cited:  Bernard  and 
Ruottc  (Foveau  de  Courmelles),  L'annee  elcctrique,  Revue  de  1901,  p.  350, 
radiated  a  young  man  for  35  minutes  witli  a  very  hard  tube  placed  15  cm. 
from  the  skin.  The  primary  current  was  one  of  15  volts  and  4  amperes,  and 
a  25  cm.  coil  was  used.  An  aluminum  plate  earthed  through  the  gas  pipes 
was  fixed  between  the  tu])e  and  the  skin.  After  fifteen  days  a  dermatitis 
developed,  which  was  not  properly  healed  after  ten  months. 

^)  Journal  des  malad.  cut.  et  .syph.,  1902,  Heft  3. 


246  RADIO-THERAPY 

sections,  of  graduated  thickness.  By  means  of  the  fluorescent 
screen  the  particular  aluminium  section  is  noted,  whose  shadow 
equals  the  density  of  shadow  cast  by  the  silver  plate,  and  thus 
some  measure  of  the  intensity  of  the  rays  is  arrived  at.  The 
apparatus,  however,  is  by  no  means  infallible,  since  the  pene- 
trating power  of  X-rays  depends  not  only  upon  the  thickness, 
but  upon  the  density  of  the  body  trav^ersed.  The  first  and  third 
of  the  author's  experiments  quoted  above  show  plainly  that  the 
effects  of  irradiation  depend  very  largely  upon  its  duration. 
While  comparatively  brief  exposures  give  good  results,  those 
which  are  too  prolonged  must  be  regarded  as  highly  dangerous. 

What  is  understood  by  too  long  a  duration  of  treatment? 

An  absolute  duration  of  exposure  must  be  clearly  dis- 
tinguished from  a  relative  one — that  is,  the  duration  of  the  indi- 
vidual sittings.  The  effect  of  one  sitting  of  a  definite  duration 
is  not  the  same  as  the  effect  of  a  series  of  sittings  whose  total  sum 
covers  the  same  length  of  time.  A  single  exposure  below  a  cer- 
tain limit  has  no  effect.  The  total  length  of  exposure  necessary 
to  produce  a  certain  effect  varies  accordingly  as  one  gives  a 
single  or  several  sittings. 

If,  for  example,  a  patient  be  irradiated  for  50  minutes  with- 
out interruption,  the  effect  on  the  skin  is  much  more  marked 
than  if  the  exposure  be  made  for  10  minutes  on  five  succeeding 
days.  The  fact  must  be  especially  borne  in  mind  when  working 
with  powerful  apparatus,  that  is  to  say,  strong  currents  and 
tubes  of  high  capacity.  If  the  treatment  is  to  be  completed  in 
one  or  very  few  sittings,  powerful  currents  and  tubes  being  to 
hand,  it  must  be  remembered  that  a  long  exposure  is  a  most 
powerful  agent,  and  that  an  "over-exposure"  of  but  a  few 
minutes  only  will  have  an  important  effect  on  the  final  result. 

In  such  cases,  therefore,  the  utmost  caution  is  necessary, 
and  the  need  for  this  is  intensified  by  the  fact  that  the  full  effects 
are  not  seen  in  different  individuals  in  precisely  the  same  time, 
although  the  irradiation  has  been  identical  in  each  case.  The 
energy  of  Roentgen-radiation  varies  inversely,  as  is  the  case  with 
light,  with  the  square  of  the  distance  of  the  ray-source.  A  photo- 
graphic plate,  whose  sensitive  surface  is  weakly  acted  upon  at 
a  certain  distance  shows  at  half  that  distance  an  effect  which  is 


TREATMENT  JriTH  X-R.IYS  247 

four  times  that  of  the  former.  1  his  fact  must  he  carefully 
borne  in  mind  when  arranging  the  position  of  the  tube,  for  a 
ditierence  of  i  or  2  centimetres  only,  when  considered  in  con- 
nertion  with  other  factors  (current  strength,  state  of  vacuum 
ot  the  tube,  relative  time  of  exposure,  etc.),  may  be  of  some 
importance. 

A  proper  estimation  of  the  intensity  of  the  X-rays  employed 
is  of  the  highest  importance.  Difterent  methods  have  been 
aci\ised  to  this  end,  but  mostly  they  lea\e  something  to  be 
desired  in  the  way  of  precision.  The  author  relies  most  on  the 
character  of  the  fluorescence  as  seen  in  the  tube.  In  soft  tubes 
the  fluorescence  is  almost  yellow  and  very  copious,  while  in  hard 
tubes  it  is  greenish,  transparent,  and  watery-looking.  The 
amount  of  fluorescence  atiords  a  fairly  good  means  of  estimating 
the  ray-intensity.  The  rate  of  interruption  of  the  primary  cur- 
rent is  a  factor  not  to  be  overlooked,  since  it  plays  an  important 
part  in  the  production  of  physiological  eftects.  One  school  of 
writers  believes  that  greater  effect  may  be  had  from  rapid  inter- 
ruptions, another  pins  its  faith  on  slower.  Upholders  of  the 
first  doctrine  argue  that  by  doubling  the  rate  of  interruption  in 
a  given  time  the  number  of  X-ray  "waves"  striking  the  skin  is 
likewise  doubled.  Whereas  the  others  hold  that  the  higher 
current-tension  obtained  by  interrupting  more  slowly  is  of 
advantage  ^) 

The  truth  probably  lies  half-way.  l^p  to  a  certain  limit 
(40-50  interruptions  per  second)  acceleration  of  the  rate  of 
interruption  is  attended  by  an  increase  of  physiological  effect. 
Beyond  this,  however,  /'.  c,  with  still  more  rapid  interruptions, 
the  effect  is  not  proportionately  increased.  Indeed,  the  author 
has  found  that  with  a  turbine  apparatus  working  at  100  inter- 
ruptions per  second,  he  could  obtain  a  certain  effect  with  fewer 
sittings  than  when  using  a  U'chnrlt's  apparatus  giN'ing  17(^0 
interruptions  per  second. 

It  is  of  the  greatest  importance  to  bear  in  mitul  the  fact  that 
the  tissues  of  different  indi\  iduals  tlo  not  jiossess  the  same  sensi- 
tiveness to  X-ravs.     Man\  authors,  it  is  true,  deny  this,  though 


'j    (j(iss)inni)i  ami  Sclicitkcl,  iMirtschr.,  I'd.   II.   II.  4.  d.    1,^0. 


248  RADIO-THERAPY 

it  would  appear  that  ev^en  they  have  met  with  differences  in  the 
mode  of  reaction  of  different  persons  ^) . 

Other  writers  attribute  a  special  susceptibility  to  reaction 
to  certain  parts  of  the  body,  moreover,  stating  that  the  colour 
of  the  slcin  and  hair  indicates  susceptibility  in  some  people. 
Thus  Jiitassy  says  that  blondes  are  especially  sensitive.  Scholtz 
has  observed  that  dermatitis  is  more  apt  to  arise  without  warning 
on  the  scalp  and  beard  than  in  other  regions.  Both  Bisserie's 
and  the  author's  experience  is  in  accord  with  this,  and  the  latter 
has  further  observed  that  reaction  is  more  readily  induced  in 
tissues  immediately  overlying  bone. 

Jiitcissy,  Beuedikt,  and  Kicubuck  noticed  that  children  and 
persons  who  are  ill-nourished  are  more  sensitive  to  the  rays,~) 
also  that  mucous  membranes,  the  face  and  the  back  of  the 
hands,  react  more  readily  than  the  face  and  the  trunlv.  The 
author  has  not  been  able  to  verify  the  statement  made  by  Hahn 
and  Alhers-Sclwnberg  to  the  effect  that  women  who  wear  veils 
have  tenderer  skins  and  are  consequently  more  susceptible  to 
X-rays.  He  has  observed,")  however,  that  skins  affected  with 
sycosis  or  fa\us,  being  already  somewhat  inflamed,  are  soon 
influenced  by  the  rays.  This  has  been  confirmed  by  others 
{Sc/iijf,  Kiejihock,  ScJioltz) .  Kicubock  denies  the  possibility  of 
some  people  possessing  an  idiosyncrasy  which  renders  them 
prone  to  excessive  reaction.  He  maintains  that  in  every  case 
the  effect  depends  simply  upon  the  amount  of  irradiation. 

1  he  whole  subject  of  Roentgen-therapy  is  still  a  vexed  one. 
There  are  those  who  would  deny  its  raisoii  d'etre,  doubting  if  it 
is  really  capable  of  producing  physiological  effects^);  others 
who  while  admitting  these  effects  are  of  opinion  that  they  sig- 


')  These  writers  do  not  say:  "The  reaction  appears  after  irradiations," 
but  rather,  "To  obtain  a  certain  effect  n-m  sittings  must  l)e  given."  If  the 
mode  of  reaction  were  identical  in  all  cases  the  effects  produced  by  a  given 
munber  of  exposures  of  the  same  intensity  would  always  arise  at  the  same 
time.     This  is  by  no  means  the  case. 

")  Halm  and  Albcrs-Schdnhcrg,  on  the  other  hand,  believe  children  to  be 
more  resistant   (Miinchen.  med.  Woch.   1901,  9-1 1). 

')  Wiener  med.  Presse,  1899,  No.  31. 

*)   Brrgiiiaun,    Vers,    der    Naturforscher   und    Aerzte    in    ]\Iimchen,    1899. 


TREATMENT  JVITH  X-RAYS 


249 


nify  dangerous  damage  to  the  body').  On  the  other  hand, 
those  who  are  agreed  as  to  the  \akic  of  the  method  are  by  no 
means  unanimous  with  regard  to  the  details  of  its  technique. 
Much  controversy  still  obtains  on  the  question  of  the  right  kind 
of  vacuum-tube. 

In  consideration  of  the  fact  that  soft  tubes  have  a  more 
powerful  effect  than  hard  ones  Kienbock  adxises  the  following 
procedure  ■)  r  An  adjustable  Roentgen-tube  whose  vacuum  has 


Fig.  75- 


been  brought  to  the  "soft"  or  "medium-soft"  stage  is  worked 
bv  means  of  a  primary  current  of  3-6  amperes,  the  interruptions 
being  secured  through  a  turbine  apparatus  at  the  rate  of  15-20 
per  second.  The  tube  must  give  rays  capable  of  penetrating 
the  thorax  of  an  atlult  at  a  tlistance  of  1-2  m.  I  his  tube  is  fixed 
about  20  cm.  from  the  skin,  ami  from  3  to  :^  sittings  of  kj  to  15 
minutes  each  are  gi\en  on  succeeding  days.       I'hc  sittings  are 


*)   Oudin,  Bartlielcmy,  Soc.  de  I  )(.Tniat()g.  ct  dc  Sypli..  3  Jnli  1Q02. 
')   Wiener  klin.  Woch.,  1900,  p.  1163. 


250  RADIO-THERAPY 

then  suspended  for  two  or  three  weeks  so  that  the  reaction  may 
develop.  After  all  reaction  has  subsided  the  sittings  are 
resumed  as  before. 

The  author  does  not  approve  of  this  method,  since  by  its 
adoption  one  hardly  knows  if  the  exposures  have  been  pushed 
too  far  or  too  little.  Now  Kaposi  ^)  has  rightly  remarked 
that  one  of  the  chief  drawbacks  to  Roentgen-therapy  lies  in  this, 
that  one  is  working  more  or  less  in  the  dark  and  is  ignorant  of 
what  has  been  really  done. 

Amongst  a  series  of  cases  which  were  for  purposes  of 

comparison    treated    exactly    on    Kieubock' s    lines    the 

author  obtained  good  results  in  two  cases  of  sycosis;  in 

a   case   of   hypertrichosis   again   results   were   negative 

— the  exposure  had  been  insufficient;  while  in  a  case  of 

favus   a   somewhat  violent   inflammation   set   in  which 

required  several  weeks  to  heal. 

The  method  indicated  in    1898  by  Schif[  and  the  author, 

w^hich  the  latter  has  since  employed  with  a  few  modifications,-) 

is  as  follows:   A  Ruhmkorff's  coil  (30  cm.")  )   is  worked  either 

from  the  main  or  from  a  6-cell  accumulator,  the  current  being 

between  i^,  and  2  amperes,  and  the  interruption  averaging  16 

per  second.     The  tube  is  hard,  yet  one  giving  a  good  greenish 

flare. 

The  tube  must  be  so  placed  that  the  most  intense  rays  pro- 
ceeding from  the  anti-cathode  strike  the  centre  of  the  region  to 
be  exposed  (Fig.  75).  It  has  been  shown  elsewhere  (p.  224) 
how  the  region  of  most  intense  radiation  may  be  discovered. 
The  distance  of  the  tube  from  the  skin  is  at  first  15  cm.,  but 
this  is  afterwards  gradually  decreased  to  5  cm.  In  like  manner 
the  sittings  are  gradually  prolonged  from  5  to  10  minutes,  and 
the  part  is  irradiated  until  signs  of  reaction  occur,  when  opera- 
tions are  suspended.     The  author  has  found  the  following  early 


')   K.  k.  Gesellsch.  d.  Aerzte,  27  Oct.  1899. 

■)  Many  other  workers  have  found  tliis  method  successful,  c.  g..  Gcorg 
J.  Midler,  Grouvcn,  Havas,  Puscy,  Zcchmcistcr,  Mcrk,  Tordk.  Schcin,  Gaston, 
Vicira,  Hall-Edwards,  Boczar,  etc. 

')  Coils  by  Keiser  &  Schmid.  Kohl,  Siemens  &  Halske,  Reinigcr,  Gcb- 
bert  &  Schall  and  Dessauer  were  used. 


TREATMENT  JFITH  X-RAYS  251 

signs  of  reaction  in  by   far  the  greater  number  of  his  cases 
treated  as  above  described  ^)  : 

1.  Intumescence  of  the  skin. 

2.  Pigmentary  changes. 

3.  Erythema, 

4.  Loosening  of  the  hair. 

5.  Subjective  symptoms. 

The  intumescence  is  an  early  sign  which  is  nearly  always  to 
be  observed.  A  cheek,  for  example,  which  is  being  treated  for 
hypertrichosis,  appears  after  about  three  weeks  fuller  and 
rounder  than  the  other;  the  skin  appears  tenser,  a  little  oilier 
and  perhaps  more  shining.  At  this  stage  no  alteration  in  the 
colour  of  the  skin  can  usually  be  observed.  Indeed,  at  first  the 
changes  are  not  very  striking  and  they  may  readily  escape  the 
notice  of  an  inexperienced  operator.  They  are,  however, 
noticed  by  the  patients  themselves,  who  usually  scrutinize  their 
skins  most  assiduously;  they  come,  therefore,  to  the  practitioner 
saying  that  the  treatment  does  them  a  lot  of  good,  and  that  they 
"look  much  better  than  before."  In  cases  where  the  sittings 
are  prolonged  for  some  time  the  intumescence  is,  of  course, 
longer  maintained,  whereby  scars  and  irregularities  in  the  skin- 
surface  are  temporarily  levelled,  and  the  general  appearance  of 
the  integument  improved.  The  intumescence  disappears  after 
the  sittings  are  suspended,  but  often  a  more  lasting  cosmetic 
effect  is  gained  through  the  resulting  desquamation.  It  must 
be  noted  that  the  intumescence  is  never  sharply  circumscribed, 
but  rather  diffuse, — its  border  cannot  be  exactly  defined. 
Finally,  the  sense  of  touch  is  not  so  useful  in  discovering  its 
presence  as  that  of  sight.  Ihe  alterations  noticeable  by  palpi- 
tation of  an  irradiated  skin  are  almost  imperceptible. 

The  question  naturally  arises.  To  what  anatomical  changes 
is  this  clinical  effect  due? 

Behrend  '^)  assumed  that  the  tissues  become  permeated  with 
a  serous  exudation  which  not  only  affects  the  parts  containing 
blood-vessels,  but  also  the  deeper  layers  of  the  epidermis,  which 


')   Wiener  med.   Presse,    1890,   No.  .31   k.  k.  Ges.  d.   Acrzte  in  Wicn,  27 
Oct.  1899.    Congr.  d.  deutsche    dcrmatolog.  GcscUsch.,  Breslau,  igoi. 
"")    Berliner  klin.  Wochenschr.,  1898,  No.  2.5. 


252  RADIO-THERAPY 

becomes  so  soaked  that  the  lymph-spaces  between  the  elements 
of  the  stratum  spinosum  are  distended.  As  a  result  the  indi- 
vidual cell-elements  are  forced  apart,  and  in  the  case  of  a 
violent  exudation  even  larger  spaces  may  be  formed,  filled  with 
serous  fluid  and  overarched  by  the  less  yielding  horny  layer  of 
the  epidermis,  thus  giving  rise  clinically  to  a  vesicle. 

The  author  is  not  aware  how  far  this  theory  of  Behrend's 
depends  upon  histological  investigation.  It  will  be  seen  later, 
however,  that  Schollz  has  verified  the  existence  of  this  serous 
exudation  into  the  tissues  by  experimenting  with  animals. 

Roentgen-radiation  often  causes  singular  pigment  changes 
in  the  skin,  and  these  may  even  be  the  first  sign  of  commencing 
reaction.  They  may  be  characterised  either  by  the  appearance 
of  freckle-like  spots  on  the  skin,  or  the  whole  exposed  area  may 
assume  a  diffuse,  slightly  yellow,  brown,  or  greyish  tint  which 
is  in  most  cases  ephemeral.  Again,  pre-existing  freckles  or  other 
pigmentary  abnormalities  may  become  darker,  or  they  may  in 
some  cases  become  somewhat  lighter  in  hue.  It  must  be  noted 
that  these  pigment  changes  very  often  make  their  appearance 
without  erythema  having  preceded  them;  they  are  evidently  not 
always  dependent  on  the  latter  phenomenon. 

A  discolouration  of  the  hair,  especially  in  the  case  of  bru- 
nettes, has  been  repeatedly  observed  as  the  first  sign  of  reaction. 
Sehrwald,^)  Gocht,'-)  GassmrDin  and  Schenkel^)  have  seen 
depigmentation  of  the  exposed  surface  with  increased  pigmen- 
tation around  its  border.  The  author  has  himself  seen  this  as 
a  later  effect  of  Roentgen-radiation,  notably  in  a  case  of  lupus 
erythematosus  treated  by  Schijj  * ) . 

In  this  case  the  pigment  seemed  as  though  it  had 
been  displaced  from  the  white  area  marking  the  site  of 
the  disease  into  its  vicinity  (Scliiff  and  Fretind,  Beitrage 
zur  Radiotheraphie,  Festschr.  f.  Hofrath,  Prof.  Neu- 
mann,   page    806.      The    author    again    saw    a    case 


^)  Deutsche  med.  Woch.,  1901,  No.  30. 

')  Fortschr.,  Bd.  I.  H.  i. 

')  Ibid.  Bd.  II.  H.  4. 

*)  Ibid.  Bd.  II,  H.  4. 


TREATMENT  iriTII   X-RJYS  253 

recently,  that  of  a  young  lady,  a  brunette,  who  had  been 
treated  for  hypertrichosis.  Dermatitis  here  had  been 
followed  by  the  appearance  of  pale  patches  in  the  skin 
surrounded  by  dark  brown  rings  of  pigment.  One 
recalls  the  fact  that  freckles  are  particularly  apt  to 
appear  on  blondes,  and  melanoses  on  white  animals. 
Ph.  J.  Pick,  who  calls  attention  to  this  fact  in  an 
able  article  (Vierteljahrschr.  f.  Derm.  u.  Syph.,  1884, 
page  24),  is  of  opinion  that  the  pigment  defect  in  the 
hair  of  animals  with  melanosis  accounts  for  its  excessive 
deposit  in  other  parts. 

The  author  concluded  from  his  researches  on  the 
physiological  effects  of  electric  discharges  on  the  skin 
that  pigmentary  accumulations  arise  from  hasmosiderin, 
which  in  its  turn  Is  the  result  of  haemorrhage  into  the 
tissues. 
5.  Ehrmann  ^)   gave  the  following  explanation  of  the  pig- 
ment-phenomena, based  on  microscopic  examination :    By  the 
direct  influence  of  Irradiation  on  the  capillaries,  the  walls  of 
which  become  adapted  for  diapedesis  (not  haemorrhage),  hyper- 
cemla    is    produced.      At    the    same    time    there    is    a    copious 
exudation  of  blood-plasma  in  which  hccmoglobln  Is  dissolved. 
This    explains    the    yellowish    tinge    of    the    hyperasmic    skin. 
Very  soon   gold-coloured   hcemoslderin   is  deposited    from   the 
colouring  matter  of  the  blood  in  the  tissue  interstices.    The 
hasmoslderln  is  absorbed  after  a  few  weeks,  until  which  time  the 
skin  retains  Its  yellowish-brown  tint.     When,  however,  the  sun's 
rays,  or  the  X-rays,  encounter  a  skin  possessing  melanoblasts 
(cells  producing  melanotic  pigment,  which  is  not  formed  within 
the   cell-spaces,    and   is   chemically    different,    moreover,    from 
hasmoslderln)  melanin  is  more  copiously  secreted  as  the  result 
of  the  irritation  of  these  cells.    Hence  the  sepia-brown  discolora- 
tion, which  may  persist  a  twelve-month. 

The  skin  of  fair-haired  people  as  a  rule  contains  fewer 
melanoblasts;  consequently  they  usually  escape  this  excessive 
brown  pigmentation. 


')  Wiener  mcd.  Woch.,  1901,  Nos.  30,  31. 


254  RADIO-THERAPY 

L.  Tordk  and  M.  Schein^)  have  observed  an 
abundant  development  of  closely  packed  comedones 
after  irradiation  of  the  face. 

The  erythema  which  is  so  often  seen  as  an  early  sign  of 
Roentgen-reaction  differs  in  character  from  most  erythemata. 
It  differs,  for  instance,  from  the  erythema  resulting  from  the 
internal  or  external  use  of  certain  medicaments  (erythema  vene- 
natum)  ;  it  has  rather  the  character  of  an  erythema  solare.  The 
skin  looks  as  though  it  had  been  much  exposed  to  the  sun,  or  as 
though  the  patient  had  been  amongst  the  glaciers.  The  ery- 
thema is  at  first  of  a  delicate  light  colour,  later  on  a  reddish- 
brown  tint  with  a  slight  bluish  cast  develops.  This  darken- 
ing of  colour  is  probably  due  on  one  hand  to  the  combination 
of  erythema  with  pigmentation,  on  the  other  to  the  fact  that 
the  hyperaemia  is  "passive."  This  erythema  of  the  skin  may  be 
either  diffuse  or  patchy. 

In  a  great  number  of  cases  loosening  of  the  hair-shafts  is  the 
very  first  sign  of  reaction.  It  is  quite  wrong  to  suppose,  as  many 
have  done,  that  this  effect  can  only  follow  after  other  inflamma- 
tory phenomena  have  been  established.  A  good  method  to  dis- 
cover this  loosening  of  the  hair  is  to  seize  two  or  three  shafts 
between  the  finger-tips  close  to  the  skin,  then,  exerting  slight 
pressure,  to  slide  the  fingers  towards  the  free  ends  of  the  hairs. 
Normal  hairs  are  not  affected  by  this  manoeuvre,  whereas 
loosened  hairs  readily  fall  out.  To  pull  forcibly  at  one  part  of 
the  hair,  either  with  the  fingers  or  with  a  forceps,  is  a  crude 
and  much  less  reliable  method;  it  is,  moreover,  one  which  is 
quite  useless  for  determining  the  earlier  and  slighter  alterations 
in  the  fixity  of  the  hair. 

In  order  that  a  reaction  may  be  recognised  early  it  is  most 
Important  that  any  patient  who  is  undergoing  treatment  for  a 
hair  affection  does  not  shave  or  otherwise  cut  the  hair  short;  in 
cases  where  the  hair  has  been  recently  cut  operations  should  be 
deferred  until  it  has  reached  a  certain  length.  Difficulties  In 
this  direction  will  often  be  encountered  In  the  case  of  women 
who  are  being  treated  for  hypertrichosis,  these  patients  being 


')  Wiener  med.  Woch.,  1902,  No.  18  ff. 


TREATMENT  IVITH  X-RAYS  .    2SS 

accustomed  to  presence  appearances  by  the  use  of  depilatories 
or  the  epilation-forceps.  Nevertheless,  the  rule  must  be  strictly 
enforced,  for  it  is  impossible  to  tell  when  closely  cropped  hairs 
are  really  loose,  the  hair-roots,  lacking  friction  on  their  shafts, 
will  otherwise  remain  for  a  long  time  in  situ,  and  may  be  only 
removed  in  the  end  by  the  lifting  force  of  fresh-growing  hairs. 
Under  the  latter  circumstances  the  falling  of  the  hair  could  give 
no  indication  whatever  for  the  suspension  of  treatment. 

Siibjc'ctke  symptoms  are  often  the  forerunners  of  a  reaction. 
They  include  itching,  burning,  and  a  feeling  of  tension,  and  are 
apt  to  be  more  marked  by  night.  It  is,  however,  in  but  rare 
instances  that  patients  will  on  their  own  initiative  mention  these 
sensations;  they  regard  them  usually  as  insignificant.  It  is 
important,  therefore,  that  they  be  informed  of  the  great  impor- 
tance of  mentioning  these  symptoms  as  soon  as  they  occur.  Some- 
times neurotic  patients  who  are  under  treatment,  especially  in 
the  later  stages,  will  suffer  from  an  attack  of  intense  pruritus 
of  the  exposed  region  often  accompanieci  by  urticaria.  Should 
this  happen,  operations  must  be  suspended.  The  above-men- 
tioned early  signs  of  reaction  are  far  from  intense  if  the  treat- 
ment is  properly  conducted,  indeed,  they  often  escape  notice  by 
beginners.  They  afford,  however,  a  most  valuable  index  to  the 
more  expert  to  the  progress  of  events,  and  enable  him  in  time 
to  complete  the  treatment  with  safety  to  his  patient.  Reference 
may  here  be  made  to  the  fact  that  suspension  of  the  sittings 
at  this  comparatively  early  stage  almost  always  meets  with 
opposition  from  the  patient.  He  often  begins  treatment  with 
somewhat  prejudiced  feelings,  inasmuch  as  he  sees  nothing  of 
what  is  going  on,  on  account  of  his  mask.  Consequently  he 
objects  to  resting  at  a  time  when  he  "hardly  feels  anything," 
and  protests  that  he  has  been  treated  insufficiently.  Hysterical 
women  who  are  being  treated  for  hypertrichosis  are  particularly 
troublesome  in  this  respect,  especially  if  during  an  earlier  treat- 
ment they  have  been  relieved  from  their  hairy  troubles.  On 
no  account,  however,  will  the  operator  who  has  a  proper  con- 
ception of  his  responsibilities  give  way  to  these  importunities. 

Both  the  methods  which  have  been  explained  in  lull  above 
have  this  in  common:    The  object  is  to  produce  a  certain  effect 


256  RADIO-THERAPY 

by  means  of  a  "normal"  intensity  of  irradiation  and  period  of 
exposure.  It  is  true  that  this  "normal"  has  been  empirically 
determined,  but  it  cannot  be  exceeded  without  danger.  One  can 
obtain  the  same  final  result  with  hard  or  soft  tubes,  weak  or 
powerful  rays,  varying  distance  of  the  tube,  etc.,  provided  the 
"dose"  be  regulated  accordingly.  In  the  first  method  the 
"normal"  is  attained  in  a  few  sittings  compared  with  the  second; 
the  final  effect  is  the  same  in  both.  Whereas,  however,  the  effect 
upon  the  skin  in  a  single  irradiation  by  the  second  method  is  very 
feeble,  in  the  first  method  it  is  fairly  strong,  owing  to  the 
employment  of  more  powerful  tubes.  Later  experience  has 
confirmed  the  author's  earlier  view,  that  by  employing  the  first 
method  the  operator  is  using  a  strong  remedy,  the  effects  of 
which  he  may  be  unable  to  control;  on  the  other  hand,  taking 
into  consideration  the  different  reacting  power  of  individuals, 
there  is  the  possibility  of  him  administering  a  "normal"  irradia- 
tion which  the  subsequeni  four-weeks  resting  time  may  prove 
to  have  been  insufficient. 

An  experiment  by  0«^i«  andBarthelemy^)  furnished 
an  interesting  proof  of  this  assertion.  They  exposed 
successively  12  patients  under  identical  conditions  of 
exposure-period,  etc.,  to  a  tube  whose  vacuum  could  not 
be  regulated.  At  the  beginning  of  the  experiment  the 
tube  was  very  soft,  towards  the  end  it  became  very  hard. 
The  first  patient,  who  had  been  exposed  to  the  "over- 
soft"  tube  showed  no  reaction  whatever.  Succeeding 
patients,  as  the  tube  became  altered  in  vacuum,  showed 
erythema,  phlyctenulae,  bullae,  loss  of  hair,  and  finally 
severe  dermatitis.  The  eleventh  patient  (the  tube  being 
now  very  hard)  showed  complete  loss  of  hair  without 
other  signs.  In  the  twelfth  patient  there  were  no  signs 
Avhatever. 
The  author  has  already  expressed  the  opinion  -)  that  the 
Roentgen  treatment  will  only  become  popular  amongst  medical 


')   II  Congr.  intern,  d'electrologie  et  de  radiologic,  Sept.  i,  1902. 

")  The  same  opinion  was  expressed  by  the  author  at  the  VII  Congress 
of  the  Deutsche  dermatolog.  Gesellschaft,  Breslau,  1901,  before  a  large  com- 
pany of  experts. 


TREATMENT  fVlTH  X-RAYS  257 

men  when  It  is  perfected  to  such  an  extent  that  by  definite 
"doses"  it  produces  definite  effects  whose  presence  informs  the 
operator  when  he  has  treated  the  patient  sufficiently  and  within 
the  hmits  of  safety.  It  is  probably  for  this  reason  that  up- 
holders of  the  "first  method"  of  treatment  have  endeavoured  to 
so  modify  it  that  it  may  meet  the  requirements,  thereby  bringing 
both  methods  more  into  line. 

Thus  Kicnbock,^)  who  at  first  called  our  method  "compli- 
cated, confusing,  unnecessary,  and  tedious,"  has  recently  recom- 
mended, in  addition  to  his  original  method,  two  more  methods 
in  which  the  total  exposure  is  distributed  over  several  sittings 
of  less  intensity.  By  these  Kienbock  -)  means  daily  exposures 
of  5  minutes  ("irradiation  of  lesser  efficiency"),  or  longer  sit- 
tings twice  a  week  ("medium  strength  irradiations,"  which  pro- 
duce their  eftect  in  about  a  fortnight). 

Scholtz  ^)  begins  with  a  comparatively  strong  exposure  in 
order  to  soon  bring  about  reaction.  At  the  first  sign  of  this  he 
promptly  reduces  the  intensity  of  the  irradiations;  these  are  con- 
tinued in  mild  doses  until  the  desired  eftect  begins  to  show  itself. 
This  plan  is  also  adopted  by  Torok  and  Schein,  and  the  author 
has  frequently  used  it  with  marked  success. 

F.  Lio?t  •*)  uses  medium-soft  tubes,  a  coil  with  spark-length 
of  30-40  cm.,  current  strength  of  3-4  amperes,  30  volts  tension, 
and  1 500-1 800  interruptions  per  minute.  In  the  earlier  sittings 
the  tube  distance  is  30-50  cm.,  and  the  time  of  exposure  5-10 
minutes.  Later  on  the  distance  is  reduced  to  5-10  cm.,  and  the 
exposure  increased  to  30  minutes. 

Gas  toil,  Vicira  and  Nicolou  ^)  use  hard  tubes  corresponding 
to  a  15  cm.  spark-length  and  to  No.  6  of  Beunoit's  radiochro- 
meter.  The  primary  current  has  an  intensity  of  5  amperes  and 
a  25  volt  tension.  Tube-distance,  15-30  cm.  Duration  of  ex- 
posures, 10  minutes  every  other  day.     Under  this  condition  the 


'->   72-  Vcrsamml.  d.  Naturf.  u.  Acrzto  in   Hamburg,   iMirtsclir.  a.  d.  Gob. 
R.,  Vol.  V,  Part  I,  p.  34- 
")   Fortschr.  a.  d.  Geb.  d.  Roentgcnstr.,  Vol.  V,  Part  I,  p.  34. 
')   Archiv.  f.  Derm,  and  Syph.,  Vol.  LIX,  Part  III,  p.  424- 
*)  VII  Cong.  d.  dcutsche    derm.  Gesellsch.  in  Breslau,   1901, 
*)  Soc.  de  dcrmatologie  ct  de  Syphilis,  July  3,  1902. 


258  RADIO-THERAPY 

hair  begins  to  fall  alter  6-11  sittings.  "Signs  of  inflammation 
were  not  observed." 

Oiidin  ^)  gives  very  brief  exposures,  using  a  soft  tube  which 
is  brought  within  5  cm.  of  the  skin.  He  exposes  at  first  for 
I  minute  only,  gradually  increasing  the  time  to  5  minutes.  He 
continues  this  treatment  until  signs  of  reddening  show  them- 
selves and  itching  is  felt. 

Before  closing  this  chapter  the  author  must  once  more  state 
his  opinion  that  in  the  patient's  interests  a  plan  which,  while 
involving  more  time,  is  yet  harmless,  and  achieves  definite  re- 
sults by  gentler  means,  is  far  preferable  to  one  which  steers 
straight  for  its  goal  with  great  energy.  The  latter  plan  is  unde- 
niably briefer,  but  may  prove  either  too  vigorous,  in  which  case 
painful  complications  are  in  store  for  the  patient,  or  insufficient, 
whereby  much  time  is  lost.  The  first  plan,  though  more  tedious, 
is  far  safer,  albeit  much  practice  and  experience  are  required  for 
its  successful  adoption.  In  fact,  this  younger  branch  of  medical 
science  may  fairly  be  considered  as  an  art. 

For  the  rest,  especially  in  view  of  the  varying  capacities  of 
different  apparatus,  the  beginner  would  do  well  to  proceed  with 
extra  caution.  He  should  first  test  his  apparatus,  finding  out  the 
correct  exposure  by  first  commencing  with  very  short  sittings 
(say  4  minutes).  Should  results  prove  negative  after  three 
weeks,  the  patient  should  be  given  3  weeks'  rest.  After  that  the 
sittings  can  be  resumed,  the  exposure  being  gradually  increased 
to  5,  6,  7,  9  m.inutes  and  so  on  until  the  desired  limit  is  reached. 
The  current  strength  and  tension,  the  tube*  distance,  etc.,  must 
be  as  already  indicated;  hard  tubes  may  be  chosen  if  they  show 
evident  fluorescence  (see  p.  247) .  When  soft  tubes  are  used  the 
total  exposures  must  not  exceed  40  minutes.  When  once  the  time 
of  exposure  necessary  to  loosen  the  hairs  with  each  series  of 
sittings  has  been  ascertained,  one  has  gained  valuable  data  for 
the  treatment  of  various  affections,  which  may  now  be  under- 
taken with  greater  conficience.  Hence,  one  may  proceed  a  little 
more  boldly,  and,  by  modifyng  the  treatment  in  accordance  with 
the  instructions  already  given,  hasten  the  cure.     The  best  and 


^)   Soc.  dc  dcrmatologie  et  de  Syphilis,  July  3,  1902. 


TREATMENT  JriTH  X-RAYS  259 

safest  plan  is  for  the  beginner  to  start  with  the  treatment  of  a 
disease  like  sycosis.  It  is  only  after  considerable  experience  he 
should  undertake  cases  of  hypertrichosis,  the  after  appearance 
of  the  skin  being  here  especially  a  matter  of  the  greatest 
moment. 

Since  it  occasionally  happens  that  a  single  irradiation,  even 
one  which  is  by  no  means  intense,  may  cause  dermatitis,  a  brief 
trial-exposure  should  be  given  in  every  fresh  case,^)  so  that  due 
allowance  may  be  made  for  the  special  susceptibility  of  any  par- 
ticular case.  Rearing  in  mind  the  law  that  the  intensity  of  an 
irradiation  varies  inversely  as  the  square  of  the  distance  between 
the  ray-source  and  the  object,  while  the  size  of  the  area  irradia- 
ated  increases  with  the  square  of  the  distance,  it  will  be  necessary 
to  increase  the  distance  between  the  tube  and  the  patient  where 
large  surfaces  are  under  treatment;  at  the  same  time  the  ex- 
posure must  be  correspondingly  lengthened.  One  must  remem- 
ber that  at  the  skin-surface  which  is  nearest  to  the  tube-wall  (the 
part  corresponding  with  the  most  brightly  illuminated  portion 
of  the  fluorescence  screen)  the  efiects  are  most  pronounced. 
When  the  whole  face  is  under  treatment  the  cheeks  should  be 
exposed  in  turn  and  then  the  chin ;  one  should  not  forget,  how- 
ever, that  by  so  doing,  some  regions  may  be  twice  exposed. 

The  question  of  screening  the  healthy  skin  from  the  action 
of  the  rays  must  now  be  considered. 

Unna  -)  recommended  a  zinc  paste  with  the  admixture  of  a 
body  arresting  the  passage  of  X-rays,  such  as  bismuth; 
Scholtz^)  tried  a  mercury  plaster;  Kaiser*)  tried  a  funnel- 
shaped  piece  of  lead  sheeting,  intending  by  this  means  to  con- 
centrate the  rays  on  the  skin  (forgetting,  however,  that  they  are 
not  capable  of  refraction  or  reflection).  Scllurmayer^')  recom- 
mended leaden  screens  which  were  "earthed"  through  a  con- 
ducting wire.  The  author  has  found  leaden  masks  the  most 
effective.      In  place  of  the  stiff,  heavy  and  comparatively  ex- 


')  Albcrs-Schdnbcr;4  (Foftsclir.  TI,  4,  181)  and  Scholts  (1.  c.)  advise  this. 

')  Monatschr.  f.  prakt.  Dcrmalologic,  1898,  Vol.  XXVI. 

')  L.  c. 

')  Wiener  klin.  Wocii.,  lOoi,  No.  31. 

")  7Z-  Vcr  amml.  d.  Naturf.  u.  Aerzte,  Hamburg,  1901. 


26o 


RADIO-THERAPY 


pensive  masks  made  by  the  plumber  for  this  purpose,  he  now 
uses  those  which  are  made  as  follows : 

A  piece  is  cut  from  a  leaden  sheet  ^  mm.  thick  (Fig.  76). 
The  measurements  are  ad  =  42  cm.,  ae  =  8  an.,  kg  =  16  cm., 
ab  =  ed  =  g  cm.,  bf  =  ch  =  12  cm.  The  sheet  has  "billroth- 
battist"  sewn  to  one  side;  at  m  and  u  two  slits  perforate  it; 
through  each  of  these  a  ribbon  passes  which  is  sewn  to  the  lining. 
The  mask  is  now  ready  for  the  upper  part  of  the  face.  In  case 
this  mask  has  to  be  worn  by  several  patients  {e.  g.,  in  out- 
patient practice)  they  should  be  instructed  to  each  bring  a  hand- 
kerchief to  be  placed  beneath  the  mask.  The  mask  may  be 
roughly  shaped  to  fit  the  face.  Apertures  should  be  cut  in  the 
mask  corresponding  to  the  diseased  area.  All  parts  of  the  body 
coming  within  the  X-ray  field  which  not  do  require  exposure 


must  be  carefully  protected  from  the  rays  by  means  of  masks. 
Thus,  if  the  chin  is  under  treatment,  not  only  the  upper  part 
of  the  face,  but  also  the  chest,  requires  protection,  and  where  the 
angle  of  the  jaw  is  the  site  of  operations,  the  shoulder  must  be 
screened. 

In  many  cases  it  is  a  good  plan  to  place  the  vacuum-tube 
within  a  lead-lined  box,  having  an  aperture  at  one  side  cor- 
responding to  the  diseased  area. 

As  a  special  protective  measure,  Kaiser^)  recommends  the 
use  of  vacuum  tubes  made  of  red  glass;  Jiitassy  ~)  again  says 
he  has  never  seen  any  bad  effects  accompanying  the  use  of  blue 
lead-oxide  tubes. 


*)  Wiener  klin.  Woch.,  1901,  No.  31. 
*)  Fortschr.,  Vol.  II,  Part  V,  p.  195. 


TREATMEXT  If'ITIl   X-R.IYS  261 

The  operator's  own  salety  must  not  be  forgotten. 
One  has  known  zealous  radiographers  who  have,  alter 
some  hours'  use  of  the  fluorescent  screen,  developed 
severe  dermatitis.  It  is  probably  cases  like  this  which 
have  led  to  excessive  precautions  being  taken  by  some  of 
those  who  busy  themseKes  with  X-ray  therapy.  Ihe 
author  has  known  a  conscientious  operator  who  only 
worked  with  an  armour  of  lead  plate,  a  leaden  helmet  on 
his  head;  his  appearance  was  scarcely  calculated  to 
soothe  the  patient. 

Undoubtedly  the  warnings  and  precautions  have 
been  exaggerated.  The  operator  should  remember  that 
the  tube  only  aflects  changes  on  a  skin  which  is  for  some 
time  exposed  to  its  Held  of  action.  He  will  avoid 
placing  his  own  skin  under  these  conditions.  A  brief 
manipulation  of  the  apparatus,  a  brief  examination  of 
the  mask,  a  change  in  the  patient's  position,  etc.,  can  be 
made  repeatedly  each  day  without  affecting  one's  health 
in  the  least.  For  the  last  6  years  the  author  has  been 
working  daily  from  6  to  7  hours  in  his  Roentgen 
laboratory  without  ill  effects;  nor  has  he  worn  protective 
appliances  of  any  kind  to  hinder  him. 

§  31.  Indications. 

We  now^  come  to  the  indications  for  the  employment  of 
Roentgen-therapy.  Physiological  experiments  shew  that 
Roentgen-radiation,  like  that  with  light  and  electricity,  has  a 
stimulating  effect  when  administered  in  moderate  amount,  but 
a  destructive  action  on  certain  tissue-elements  (cells)  when 
employed  with  greater  intensity.  We  may  assume  that  when 
acting  beneficially  the  rays  modify  the  process  of  nutrition  in 
badly-healing  ulcerative  conditions  and  in  paretic  states  of  cer- 
tain tissues,  thereby  promoting  the  healing  of  the  former  and 
the  resumption  of  function  in  the  latter  (<'.  i^.,  the  hair  inipill.u 
in  alopecia  areata).  It  would  ai)p(.ar  by  no  means  unlikely  that 
the  irritant  effect  of  the  irradiation,  like  that  of  certain  chemical 
agents   (silver  nitrate,  copper  sulphate,  camphor,  etc.),  stimu- 


262  RADIO-THERAPY 

lates  the  function  of  the  connective-tissue  cells,  thereby  promot- 
ing scar-formation.  Since  this  stimulating  effect  penetrates  more 
deeply,  it  would  appear  applicable  in  cases  where  chemical 
agents,  by  reason  of  their  more  superficial  action,  are  useless. 

The  X-ray  method  is  especially  applicable  for  certain  patho- 
logical conditions  in  which  the  lesions  are  widely  spread;  for 
others  which  are  more  circumscribed  surgical  treatment,  treat- 
ment by  drugs,  or  the  "light-method,"  are  preferable. 

In  by  far  the  greater  number  of  cases  the  destructive  action 
of  X-rays  is  what  is  called  for;  this  is  especially  so  in  affections 
which  have  their  seat  in  cellular  structures,  such  as  the  epidermis, 
the  glands,  and  the  hair  follicles,  or  in  which  the  essential  fea- 
ture is  an  over-production  of  cellular  elements,  such  as  psoriasis 
and  epithelioma. 

Clearly,  however,  both  the  destructive  and  restorative 
properties  of  Roentgen-radiation  can  often  find  their  metier  in 
one  and  the  same  disease;  thus  the  healing  of  a  lupus  may  be 
due  as  much  to  the  stimulating  effects  of  the  rays,  whereby 
hyperaemia  and  improved  nutrition  are  afforded  and  scar- 
formation  assisted,  as  to  the  destructive  action  upon  the  dis- 
eased tissue. 

The  following  groups  of  diseases  suitable  for  X-ray  treat- 
ment may  be  classified  from  a  purely  empirical  and  histological 
standpoint: 

1.  The  so-called  diseases  of  the  hairs  (including  those  of 
the  hairy  skin) . 

In  this  group  we  may  include  all  those  abnormal  conditions 
for  the  cure  of  which  epilation  is  the  first  desideratum,  whether 
or  not  other  effects  of  irradiation  are  called  for  (favus,  sycosis, 
folliculitis  barbae,  blepharitis,  dermatitis  papillaris  capillitii, 
trichotylosis,  hypertrichosis,  alopecia  areata). 

2.  Ulceration  processes  in  the  skin. 

In  this  group  we  include  not  only  simple,  non-infected 
ulcerations,  in  which  irradiation  acts  favourably  by  reason  of 
its  stimulating  effects,  but  also  those  skin  affections  due  to  direct 
infection  which  so  often  end  In  ulceration.  Here  we  utilise  the 
destructive  action  of  the  rays  upon  the  morbid  tissues  and  so 
prevent  further  infection  of  surrounding  tissues  (lupus  vulgaris, 


TREATMENT  II  IT  11   X-KAYS  263 

scrofulodermia,    tuberculosis   cutis,    epithelioma,    ulcus   rodens, 
lepra,  mycosis  hingoides,  atonic  and  varicose  ulcers,  etc.). 

3.  Acute  and  chronic  exudative  dermatitis  ( inHammations) 
and  granulation- formations.  The  explanation  of  the  good 
effects  obtained  in  diseases  of  this  class  is  still  obscure;  perhaps 
it  is  to  be  found  in  the  destructive  action  of  the  rays  upon 
inflammatory  products.  Groiive/i  and  Scholtz  ha\e  shewn  that 
this  is  so  in  the  case  of  psoriasis  and  lupus. 

It  would  seem  not  unlikely  that  the  high-tension  electricity 
already  referred  to  (p.  162),  as  streaming  from  the  tube,  plays 
a  considerable  part. 

This  group  includes  eczema,  psoriasis,  prurigo,  lichen  ruber, 
pemphigus,  lupus  erythematosus,  acne  vulgaris  and  rosacea, 
furunculosis. 

4.  Diseases  which  owe  their  origin  to  morbid  changes  in  the 
blood-vessels. 

The  histological  changes  in  the  blood-vessels  which  can  be 
proved  to  follow  irradiation  explain  the  good  results  obtained 
with  this  class  of  disease  (nasvus  flammeus). 

5.  Progressive  disturbances  of  nutrition  in  the  skin  (ver- 
rucae,  naevi,  spili,  elephantiasis). 

/.    Diseases  of  tlic  Hair  a}id  IIair\  Regions. 

Favus   capillitii. 

Complete  epilation  of  the  whole  scalp  is  an  essential  feature 
in  the  Roentgen  treatment  of  this  affection.  If  the  scalp  be  only 
partially  denuded  of  hair,  recrudescence  of  the  disease  is  prac- 
tically certain,  the  fungus  growing  again  from  the  hairy  foci 
where  it  has  been  left.  In  order  that  the  whole  scalp  mav  be 
exposed  the  tube  should  be  first  placed  o\-er  the  mitldle  of  the 
frontal  region,  next  opposite  the  sides  of  the  head  (with  the 
anti-cathode  opposite  the  middle  point  of  a  line  between  the 
ear  and  vertex),  and  finally  opposite  the  centre  of  the  occiput. 
The  tube  shoultl  be  placed  at  some  distance  (25-30  cm.),  so 
that  as  large  a  surface  as  possible  may  be  irratliated,  ami  each 
exposure  should  be  from  6  to  10  minutes. 


264 


RADIO-THERAPY 


As  a  rule,  a  somewhat  intense  irradiation  is  necessary  for 
the  cure  of  favus;  this  is  probably  due  to  the  thick  hairy  coating 
of  the  diseased  parts.  (Hair  does  not  materially  prevent  the 
penetration  of  X-rays;  it  is,  however,  a  very  bad  conductor  of 
electricity.)  Before  commencing  operations,  the  hair  should  be 
cut  to  about  the  length  of  2  cm. 

The  usual  course  of  events 
is,  that  after  about  3  weeks 
(when  hard  tubes  and  weak 
currents  have  been  used),  the 
hair  is  found  to  be  loosened 
on  grasping  it,  or,  on  parting 
the  hair,  the  skin  is  seen  to 
be  slightly  reddened.  Within 
the  next  2  weeks  the  hair 
falls  out  in  a  circular  patch. 
Any  scutula  in  this  region 
exfoliate,  leaving  superficial, 
pale-red,  oozing  excoriations 
behind,  which  very  soon  (in 
about  8  days)  become  cov- 
ered with  skin.  The  part  then 
presents  a  smooth,  shining 
appearance  (see  Fig.  77),  and  about  6  or  8  weeks  after  the 
termination  of  irradiation  becomes  covereci  with  lanugo;  later 
on  the  scalp  fully  recovers  its  hair.  In  many  cases  the  scalp 
remains  permanently  cured,  and  this  result  may  be  confidently 
expected  if  a  relapse  does  not  show  itself  within  10  weeks. 
Sometimes,  however,  a  slight  relapse  necessitates  a  short  supple- 
mentary treatment. 

Torok  and  Sclie'iii  believe  that  relapses  are  not  due 
to  fungus  being  left  behind  in  the  hair  follicles,  but  to 
fresh  infection  from  without.     Hence  the  advisability 
of  treating  the   whole   of  the   scalp   as   above   recom- 
mended. 
As  an  extra  safeguard  against  relapse,  the  following  oint- 
ment may  be  used  for  the  bare  places  on  the  scalp  after  reaction 
has  subsided : 


Fig.  77. — Favus  capillitii.  Occiput, 
treated    with   X-Rays. 


TREATMEM  jriTIJ   X-RJYS  265 

Glj'cerin  acid,   carbolic     .         .         .         .         .         .2.5 

Lanolin       .         .         .         .         .         .         .         .         .     50  .  o 

This  is  to  be  thoroughly  rubbed  night  and  morning  into  the 
scalp  by  the  patient,  the  object  being  to  get  the  carboHc  acid 
(which,  according  to  Ccildcro}u\^)  is  the  best  destroyer  of  the 
fungus)  well  into  the  hair  follicles.  With  this  method  very 
obstinate  cases  of  fa\us  may  be  cured  in  a  few  weeks'  time. 

The    author    knows    of    several    cases    which    have 

remained  well   since  this  treatment,   which  took  place 

from  I  to  3  years  ago. 

Should  the  carbolic  treatment  fail  to  prevent  relapse,   the 

Roentgen  method  must  be  repeated  once  or  twice.     Care  must 

be  taken,  however,  to  avoid  strong  reactions;  if  the  latter  are 

frequently  repeated  the  scalp  will  remain  permanently  bald. 

It  will  very  often  happen  that  old  cases  of  fa\us 
which    ha\'e    been    correctly    and    carefully    treated   by 
X-rays  shew  bald  patches  after  healing.    These  are  not 
due  to  irradiation,  but  are  the  effects  of  the  disease  itself. 
The  beneficial  effects  of  this  treatment  in  the  case  of  favus 
do  not  depend  upon  any  parasiticidal  properties  of  the   rays 
themselves.     We  shall  see  later  that  the  rays  possess  practically 
no  qualities  of  this  kind,  and  the  fungus  on  the  fallen  hairs  is 
not  found  to  ha^•e  in  any  way  suffered  in  vitality.     The  good 
apparently  consists  in  keeping  large  areas  of  the  scalp  bald  for 
a  considerable  time;  in  this  way  much  \'antage  ground  for  the 
fungus  is  eliminated  with  a  great  part  of  the  fungus  itself,  and 
diseased  hairs  are  removed  which  would  otherwise  retard  the 
healing  process.     Then  there   is  the  stimulative   effect  of  the 
irradiation  to  be  considered,   which   improves  the  nutrition  of 
the  hair  follicles;  also  a  peculiar  action  ol   the  rays  in  causing 
degeneration  of  the  cell  elements  among  which  the  fungus  pro- 
liferates, and  so  indirectly  acting  inimically  on  the  latter.     L^p 
to  the  present  time  no  minute  histological  investigation  in  this 
line  ha\e  been  published. 

7  he  favourable  results  obtained  by  this  iTiethcxl  of 
treating    fa\us,     which    was    first    introduced    by    the 


'j   Ciiornals  Italian,  dcllc  malatl.   vencr..   i.  Fasc.      1S99. 


266  RADIO-THERAPY 

author^)  (and  published  later  in  connection  with 
Schiff),  have  been  confirmed  by  Ziemsscn,-)  Neu- 
mann,') Albers-Schdnberg,*)  Hahn,')  Grouven,'') 
Lion,')  Norman  JJ'alker,"-)  Scholtz,'')  and  Spiegler,^'^) 
Gaston  and  Nicolun,^^)  Boczar  and  Bnkofsky.  Spiegler 
states  emphatically  that  the  method  radically  cures  favus 
in  a  shorter  time  than  any  other  known  method,  and  is, 
in  fact,  the  best  possible  means  for  treating  the  disease. 

Sycosis  vulgaris   and   Folliculitis   barbae. 

The  mode  of  application  of  the  Roentgen  treatment  for  this 
class  of  affection  must  be  guided  by  circumstances,  such  as  the 
character  of  the  sycosis  and  other  conditions  to  be  considered 
later.  If  we  are  dealing  with  an  acutely  suppurating  process, 
tending  to  excoriation,  it  is  better  to  give  but  few  sittings 
(4  to  6)  of  8-10  mintues'  duration  each,  using  a  hard  tube  at 
a  distance  of  15  cm.  In  such  cases  even  this  brief  treatment 
suffices  to  determine  very  evident  results,  the  skin  becoming 
drier,  the  pustules  drying  up  without  fresh  pustular  formation, 
the  infiltration  absorbing,  and  the  itching,  pain,  and  tension 
gradually  lessening;  all  this  happens  without  the  loss  of  hair. 
The  appearance  of  these  signs  and  symptoms,  together  with  a 
darker  reddening  of  the  skin,  should  be  an  indication  for  sus- 
pending the  treatment.  Should  there  be  a  relapse  after  a  few 
weeks,  the  process  may  have  to  be  repeated  once  or  even  several 
times.     More  powerful,  but  more  radical,  effects  are  obtained 


')  Frcund,  Wiener  med.  Woch..  1897,  No.  19,  Wiener  dermatol.  Ge- 
sellsch.,  May  10,   1899.    Fortschr.,  Vol.  ITI,  j  .   109. 

■)  Aerztl.  Verein  in  Miinchen,  June  8.  1898. 

^)  K.  k.  Gesellsch.  d.  Aerzte,  19  Oct,  1900. 

')  Aerztl.  Verein  in  Hamburg,  18.  Oct.  1898,  and  Fortschr.  Ill,  Part  IV, 
p.  160. 

^)  Aerztl.  Verein  in  Hamlnirg,   19  Nov.   1900. 

^)  Fortschr..   IV,    Part   V,  p.     183. 

')  VII  Dermatol.  Gesellsch.,  Breslaii,  1901. 

")  Lancet,  1900,  January,  p.  27. 

")  Arch.  f.  Derm.  u.  Syph.  Vol.  LIX,  Part  III. 

")  Wiener  Klin.  Woch..    1900,  p.   1094. 

")  Soc.  de  dermatolog.  et  de  Syph.,  July  3,  1902. 


TREATMEXT  /mil  X-RJYS 


267 


by  epilation,   which  is  produced  by  stronger  irradiations    (see 

below,  also  Figs.  78  and  79). 

In  the  treatment  of  this  kind  of  skin-affection 
(tolliculitis  barbie)  by  means  of  X-rays,  it  sometimes 
happens  that  the  skin  reacts  vnolently  after  compara- 
ti\ely  few  (3  to  5)  and  weak  irradiations;  the  reaction 
partakes  rather  of  the  nature  of  an  exacerbation  of  the 
sycotic  process  than  of  an  ordinary  Roentgen-dermatitis. 
Numerous  fresh  pustules  appear,  which  often  run 
together;  the  whole  skin  becomes  tense  and  exceedingly 
paintul.    Often  deep-seated  abscesses  are  formed,  where 


Fig.   78. 


Fio.   79. 


the  pus  is  collected  sub-cutaneously  in  considerable  quan- 
tities.    Since  the  skin  is  already  highly  intumescent,  so 
that  the  addition  of  Roentgen  irradiation  with  its  effects 
might  even  induce  sloughing,  the  author  in  such  cases 
suspends  the  treatment,  applying  appropriate  dressings 
until  the  acute  inflammation  has  subsided,  after  which 
the  sittings  may  be  cautiously  recommenced. 
The  sycosis  again  may  manifest  itself  in  the  shape  of  small, 
red,  infiltrated,  superficially  scaling  nodules.      These  occupy  the 
site  of  the  follicles,  being  piercctl  by  the  hairs.     In  this  \'ariety 
of  the  disease   (acne  pilaris,   Bcsiiier,  ulerythema  sycosiforme, 
folliculitis  barba?) ,  it  is  advisable,  if  the  patient  can  conveniently 
remain  beardless  for  some  time,  to  continue  the  treatment  to  the 
stage  of  epilation.     Since  a   reaction  is  soon  obtained  in  these 
cases,    on    account   ol    the   pre-existing    inllammation,    the   skin 


268  RADIO-THERAPY 

should  not  be  exposed  for  more  than  14  days  with  hard  tubes. 
After  this  period,  as  a  rule,  the  commencement  of  reaction  is 
indicated  by  increased  tension  in  the  skin,  with  smoothening  of 
its  surface  and  a  deep-red  appearance.  Loosening  of  the  hairs 
soon  follows. 

In  order  that  we  may  be  in  a  position  to  recognise  the  impor- 
tant sign  of  loosening  of  the  hair,  the  patient  must,  at  the  out- 
set, be  told  not  to  shave  or  otherwise  interfere  with  the  beard; 
nor  should  the  treatment  be  undertaken  before  the  hair  has 
reached  such  a  length  that  it  can  be  grasped  by  the  finger-tips. 

It  often  happens,  however,  that  the  treatment  cannot  be 
pushed  to  the  stage  of  epilation,  many  patients  being  obliged 
for  social  reasons  to  retain  the  beard.  In  such  cases  it  is  advisa- 
ble (as  with  cases  of  the  first  kind)  to  proceed  more  gently, 
exposing  the  skin  only  until  the  pustular  and  nodular  formation 
ceases,  repeating  the  process  after  three  weeks'  interval  until 
no  further  lesions  manifest  themselves. 

It  is  by  no  means  clear  to  what  we  are  to  attribute  the 
favourable  action  of  Roentgen-radiation  in  this  disease. 

The  observation  that  epilation  of  the  hairs  in  the  affected 
region  is  a  better  procedure  than  shaving  permits  of  the  assump- 
tion that  good  results  are  due  not  so  much  to  the  better  pene- 
tration of  medicaments  after  epilation,  as  to  the  actual  removal 
by  this  procedure  of  an  agent  which  maintains  the  follicular 
inflammation;  just  as  gauze-strips  introduced  within  an  abscess- 
cavity  prevent  the  latter  from  healing,  although  freely  granu- 
lating, so  the  presence  of  a  dead  hair  may  conceivably  interfere 
with  the  healing  of  a  follicle  whose  walls  are  in  a  state  of  inflam- 
mation. The  author  assumed,  therefore,  that  keeping  the  skin 
hairless  for  some  time  would  have  a  beneficial  effect  on  the 
process,  and  on  this  ground  recommended  the  use  of  X-rays  in 
the  treatment  of  sycosis  and  favus.^) 

Kaposi'-)  was  of  the  opinion,  however,  on  being  shewn  a 
case  of  this  kind  by  Schiff  and  the  author,  that  sometimes  a 


^)  Wiener  med.  Woch.,  1897,  No.  19 — "Light  Treatment,"  etc. — Compte. 
rend,  du  XII  Cong,  internat.  do  medicine,  Moscow,  1897,  Dermatolog.  Section, 
p.  414- 

^)  Wiener  dermatolog.  Gesellsch.,  May  10,  1899. 


TREATMENT  IFITH  X-RJYS  269 

sycosis  is  dependent  on  the  irritation  resulting  from  certain 
anomalies  in  the  hair-growth  (such  as  the  presence  of  several 
hairs  in  one  follicle,  or  a  want  of  proportion  between  the  diame- 
ter of  the  hair  and  the  follicular  lumen),  and  that  reappear- 
ance of  the  hairs  would  be  associated  with  relapse  of  the  disease. 
It  must,  of  course,  be  admitted  that  relapse  is  common  in  cases 
of  sycosis.  Still  Kaposi's  view  is  hardly  justified,  for  if  in  these 
cases  sycosis  were  actually  provoked  by  the  anomalies  referred 
to  above  (follicles  with  several  hairs,  or  hairs  of  too  large  a 
size),  the  first  visible  signs  of  new  hairs  would  inevitably  be 
accompanied  by  traces  of  the  disease.  This  is,  however,  not  the 
case.  In  all  these  cases  the  hairs  rapidly  grow  again,  and  in 
normal  fashion.  The  skin  appears  healthy,  and  remains  so  for 
some  time.  Then,  after  the  patient  has  apparently  had  a 
healthy  beard  for  a  while,  there  comes  a  recurrence  one  day  of 
his  sycosis.  This  can  be  speedily  removed  in  4  or  5  sittings, 
without  having  to  push  the  treatment  to  the  stage  of  epilation. 
According  to  Kaposi,  a  radical  cure  of  sycosis  associated 
with  anomalous  growths  of  the  hair  is  not  possible  by  means 
of  Roentgen  treatment.    This  view  is  not  correct,  however. 

Of  17  cases  of  sycosis  treated  by  the  author  up  to 
November,  1901,  5  cases  were  thoroughly  cured  by  the 
first  course  of  sittings;  in  5  cases,  i;  in  three  cases,  2, 
and  in  i  case  3  supplementary  sittings  were  required 
for  a  permanent  cure.  Of  the  remaining  3  cases,  some 
are  still  under  treatment,  the  rest  not  having  put  in 
an  appearance  since  the  first  sitting.  These  results  shew 
that  sycosis  is  certainly  amenable  to  treatment  by  irra- 
diation. Gassmann  and  Schenkel^)  report  a  case  so 
treated  which  had  remained  well  a  year  later.  Albers- 
SchonberiT  and  Hahn,-)  Grotiven,^)  Spiegler,*)  Lion,'') 
and     Scholtz'')     G.     H.    Lancashire,'')     Gaston     and 


')  Fortschritte  auf  dcm  Geb.  d.  Roentgenstr.,  Vol.  II,  p.  i. 

';  Ibid.  Vol.  Ill,  p.  160;  Aerztl.  Vercin  in  Hamburg,  19  Nov.  1900. 

')  Niederrh.  Gesellsch.  f.  Natur  und  Heilkundc  zu  Bonn,  Feb.  2,  1900. 

*)  Wiener  derm.  Gesellsch.,  Nov.   14,  iQOO. 

')  VII  Cong.  d.  deutsch  dermatoloc?.  Gesellsch.,  Breslau,  1901. 

•)  Archiv.  f.  Dermatolog.  u.  Syph.,  Vol.  LIX,  Part  III.  ^ 

')  Brit.  Med.  Journal,  May  31,  1902, 


270  RADIO-THERAPY 

Nicolou^)    also   report   the   radical   cure   of   obstinate 
cases. 

From  these  reports  we  may  conclude  that  a  radical  cure  of 
sycosis  may  be  effected  in  a  comparatively  short  time,  very  often 
in  a  single  series  of  sittings.  Moreover,  in  the  majority  of 
cases,  there  is  no  need  for  bringing  about  Roentgen-dermatitis 
or  permanent  loss  of  hair,  as  has  been  suggested  by  two  writers 
on  the  subject. 

The  prospect  of  cure  by  this  method,  which  was  first  recom- 
mended and  used  by  the  author  himself,  is  therefore  quite  good. 
The  treatment  may  be  combined,  if  desired,  with  the  use  of 
drugs.  In  that  case  a  15-30%  sulphur-oil  may  be  used,  after  all 
inflammatory  signs  of  reaction  have  subsided. 

The  relapses  which  undoubtedly  occur  from  time  to  time 
after  the  employment  of  radio-therapy  in  this  disease  are  urged 
sometimes  as  an  argument  against  the  method.  But,  after  all, 
the  repetition  of  the  sittings  after  six  weeks  or  so,  followed 
perhaps  by  yet  another  course  of  sittings  later  on,  is  no  great 
hardship  to  the  patient.  The  inconvenience  is  one  that  is  amply 
compensated  for  by  the  patient's  feeling  that  he  is  no  longer  a 
conspicuous  object  for  pity  amongst  his  fellows.  One  must  bear 
in  mmd  what  the  ordinary  treatment  of  the  disease  commonly 
entails,  viz. :  constant  treatment  for  a  very  long  period,  daily 
shavings  and  epilation  of  the  tender  skin,  unsightly  dressings 
which  may  bar  the  patient  from  society.  The  fact  that  he  may, 
after  a  painless  treatment  by  X-rays  which  inconveniences  him 
but  little  and  lasts  perhaps  three  weeks,  be  made  once  more 
presentable  is  surely  an  argument  in  favour  of  radio-therapy. 

Recently  Ehrmann  ~)  has  shewn  that  the  disease  called  by 
him  "sycosis  scleroticans,"  but  which  is  more  generally  known 
by  Kaposi's  title  of  "dermatitis  papillaris  capillitii,"  can  only  be 
cured  by  Roentgen-treatment  or  electrolysis. 

The  author  treated  such  a  case  in  which  the  disease 
was  accompanied  by  nodular  glandular  infiltrations  the 
size  of  a  walnut.      After  7  sittings  the  hair  became 


•)  L.  c. 

0  Wiener  med.  Woch.,  1901,  Nos.  30,  31. 


•      TREATMENT  JVITH  X-RAYS  271 

loosened,  and  the  nodules  decreased  in  size.  A  second 
course  of  treatment  acted  still  more  energetically.  The 
technique  is  the  same  as  for  ordinary  sycosis. 

Hyphogenic   Sycosis  (Trichophytosis). 

Groircen,^)  H.  Zechmeister -)  and  Lion^)  report  good 
results  with  this  disease.  Zechmeister  obtained  a  radical  cure  in 
one  case  after  a  single  course  of  21  sittings,  the  exposures  lasting 
from  5  to  15  minutes  each  and  the  tube-distance  being  from 
25  to  15  cm.  He  used  hard  tubes,  and  noted  the  spontaneous 
disappearance  of  a  fluctuating  tumour,  the  size  of  a  hazel-nut, 
which  had  existed  within  the  zone  of  disease. 

Bruno  Chaves  ^)  recommended  the  treatment  for 
herpes  tonsurans.  /.  Pollitzer  informed  the  writer  that 
he  obtained  good  results  also  with  this  affection. 

Blepharitis. 

The  author  had  repeatedly  observed  that  patients  who  were 
under  the  Roentgen-treatment  for  sycosis  barbae,  eczema  faciei, 
acne  rosacea,  lupus  vulgaris  of  the  face,  were  incidentally  soon 
cured  of  a  co-existing  blepharitis.  He  published  the  first  case 
of  this  kind  in  conjunction  with  E.  Schiff ;  this  was  a  case  com- 
plicating a  chronic  eczema  of  the  beard.  Since  that  time  he  has 
treated  3  cases  of  uncomplicated  blepharitis. 

As  a  rule  the  diseased  region  reacted  after  4-9  weak  irra- 
diations of  the  closed  eye,  using  hard  tubes.  Response  to  the 
treatment  was  quickly  obtained,  whether  the  disease  was  of  the 
ulcerating  or  scaly  type.  Crusts  became  detached,  the  colour 
of  the  part  became  lighter,  excoriations  skinned  over,  and  the 
skin  became  once  more  healthy  in  appearance.  All  this  hap- 
pened without  the  eyelashes  falling,  and  no  after-treatment  by 
drugs  was  necessary.  The  accompanying  conjunctival  catarrh 
improved  rapidly  after  the  cure  of  the  blepharitis. 


•)  L.  c. 

")  Monatsch.  f.  prakt.  Dcrmatologic,  Vol.  XXXII,  No.  7. 

')  Giorn.  Italiano  dcllc  Alal.  Vcn.  c  dcUa  Pcllc,  Fasc.  III.  1900. 


272  RADIO-THERAPY 

Trichotylosis   (Trichorrhexis   nodosa). 

The  author  has  used  Roentgen-treatment  in  a  case  of  this 
peculiar  disease,  the  origin  of  which  is  as  yet  unknown.  This 
was  a  remarkably  obstinate  instance  of  the  affection,  which  had 
for  years  withstood  other  methods  of  treatment. 

The  patient,  whose  moustache  presented  the  charac- 
teristic appearance  of  this  disease,  had  twelve  sittings  in 
September,  1901.  The  apparatus  comprised  a  25  cm. 
coil,  worked  from  a  supply-current  of  6-8  amperes  and 
no  volts;  hard  tubes  were  used,  the  sittings  occupied 
7-10  minutes  each,  and  the  tube-distance  was  10  cm. 
Slight  erythema  and  partial  falling  of  the  hair  ensued. 
Unfortunately,  about  this  time  the  treatment  had  to  be 
interrupted.  After  6  weeks'  time  the  hairs  "began  to 
grow  again  in  a  normal  manner.  At  the  present  time 
(April,  1902),  the  patient  has  a  normal  moustache,  the 
.  hairs  of  which  average  2-2}  cm.  in  length  and  shew  no 
abnormality  when  examined  microscopically.  (Later 
note :  Some  trifling  relapse  is  noted  at  the  places  from 
whence  the  hair  had  not  previously  fallen  under  expos- 
ure. But  the  new  growth  of  hair  appears  quite  healthy 
six  months  after  the  treatment.  The  patient  is  recom- 
mended further  and  more  energetic  treatment  with  the 
rays. ) 

Alopecia  Areata. 

R.  Kienhock  ^)  treated  a  man,  st.  26,  who  had  for  over 
3  years  suffered  from  severe  alopecia  areata  of  the  whole  head, 
by  the  Roentgen  method,  giving  six  sittings  of  20  minutes  each 
with  a  tube-distance  of  20  cm.  He  exposed  the  frontal  region 
only. 

The  small  lanugo  hairs  soon  fell  out  over  the  irradiated 
area,  and  were  succeeded  two  months  later  by  a  strong  growth 
of  dark  and  normal  hair.  The  rest  of  the  scalp,  which  had  not 
been  treated,  retained  its  diseased  condition.     Kienbock  con- 


*)  K.  k.  Gesellsch.  d.  Aerzte  in  Wien,  Nov.  2,  1900. 


TREATMENT  JFITH  X-RAYS  273 

eluded  that  the  irradiation,  with  its  consequent  epilation,  had 
determined  the  fresh  growth  of  normal  hair. 

G.  HolzknccJit  ^)  soon  after  this  reported  another  case  in 
which,  after  5  sittings  of  10  minutes  each  with  a  20  cm.  tube- 
distance,  the  same  result  was  obtained.  In  this  case,  however, 
the  epilation  was  not  complete,  a  ring  of  thick,  black  hairs  being 
left  surrounding  each  plaque.  The  plaques  themselves  became 
reddened  3  weeks  after  the  irradiation,  whilst  the  healthy  por- 
tion of  the  scalp  (in  which  reaction  had  shewn  itself  after  8 
days)  remained  pale.  New  hair  first  grew  on  the  plaques, 
which  soon  became  covered  with  soft,  thick  black  hairs;  this 
occurred  before  the  healthy  portion  of  the  scalp  (which  had 
been  denuded  by  the  rays)  recovered  its  hair. 

In  these  cases  fresh  hair  grew,  as  is  usual  after  Roentgen- 
epilation,  two  months  after  the  last  exposure.  In  two  more 
cases  similar  results  were  achieved.-) 

Holzknecht  recommends  two  methods  of  treating  alopecia 
areata  :  ( i )  in  which  only  the  plaques  themselves  are  irradiated, 
together  with  a  ring  i  cm.  wide  surrounding  them  where  the 
disease  is  presumably  latent  (the  rest  of  the  skin  is  protected 
by  lead  masks;  (2)  in  which  the  whole  scalp  is  exposed, 
including  both  healthy  and  diseased  areas. 

The  above-mentioned  two  cases  of  alopecia  areata  shewed 
unmistakably  that  Roentgen-radiation  caused  the  growth  of 
fresh  hair.  Do  we  possess  in  this  method  a  specific  for  the 
affection? 

The  author  treated  in  this  manner  a  boy,  est.  12, 
who  had  alopecia  areata  capitis.  After  8  sittings  of  10 
minutes  each,  with  a  hard  tube,  lanugo  appeared  in  all 
the  bare  places,  one  plaque  indeed  shewing  a  fresh 
growth  of  black  hair.')  In  this  case  there  was  no  pre- 
liminary falling  of  the  hair.  Improvement,  however, 
was  not  maintained  when  the  treatment  was  continued. 


')  K.  k.  Gcsellsch.  d.  Acrztc  in  \\\vn.  7  Dec.  1900.  Wiener  k]in.  Rund- 
schau, 1901,  Nos.  41  and  7;;^.  Versamml.  d.  Naturf.  u.  .^crztc,  Hamburg,  igoi. 
Fortschr.  a.  d.  Gel),  d.  R..  Vol.  V.  No.  i.  p.  62. 

*)   Wiener  dermatolog.  Gesellsch.,  Feb.  20,   1901. 

')  K.  k.  Gesclbch.  d.  Aerzte,  Dec.  7,   1900. 


274  RADIO-THERAPY 

J .  Neumann  ^)  rightly  insists  that  in  these  cases  we  must 
bear  in  mind  the  possibility  of  a  spontaneous  cure.  In  connec- 
tion with  this  point  we  may  recall  the  fact  that  alopecia  areata 
which  has  involved  the  entire  scalp,  in  the  case  of  elderly  people, 
is  generally  incurable,  whereas  healing  is  the  rule  with  younger 
people.  The  discreet  type  of  the  affection  again  usually  heals 
of  itself  in  due  time. 

Few  data  are  to  hand  of  this  particular  branch  of  X-ray- 
therapy,  nevertheless  it  is  clear  that  it  has  been  by  no  means 
universally  successful.  Holzknecht  -)  found  some  of  his  cases 
to  be  absolutely  refractory,  and  Kienbock  "")  himself  reports  to 
the  same  effect.  The  author  has  had  the  same  experience  in  two 
instances,  and  has  learned  from  private  communications 
received  from  several  Viennese  dermatologists  that  they  also 
failed  in  several  cases. 

We  shall  probably,  therefore,  have  to  abandon  the  hope 
of  curing  universal  alopecia  by  the  X-ray  method,  since  it 
often  fails  to  improve  even  the  less  severe  forms  of  this 
malady. 

Kienbock  attempts  to  explain  the  beneficial  effects  of 
Roentgen-radiation  in  alopecia  areata,  when  these  do  occur,  by 
ascribing  some  parasiticidal  qualities  to  the  rays.  According  to 
this  writer,  moreover,  it  is  equally  reasonable  to  expect  good 
results  if  the  disease  be  regarded  as  atrophoneurosis.  With 
regard  to  the  first  point,  it  has  not  yet  been  demonstrated  that 
all  cases  of  alopecia  areata  are  of  microbic  origin.  Then  again, 
X-rays  cannot  be  accepted  as  possessing  any  microbicidal  proper- 
ties at  all.  Even  supposing  them  to  be  so  endowed,  the  irradia- 
tion would  have  to  be  so  vigorously  maintained  for  a  long  time, 
in  order  to  destroy  the  organisms,  that  serious  injury  to  the  skin 
could  hardly  be  avoided.  Finally,  no  experimental  proof  has  as 
yet  been  forthcoming  of  the  destruction  of  Saboiiraud's  micro- 
organisms in  this  manner. 


^)   K.  k.  Gesellsch.  d.  Aerzte  in  Wien,  Nov.  2.  1900. 
^)   Wiener  klin.   Rundschau,   1901,   No.   41. 

')  Verhandlungen    d.    deutschen    dermatolog.    Gesellsch.,    VII    Congress, 
p.  447- 


TREATMENT  HAT  11   X-RAYS  275 

The  theory  advanced  by  several  v^rlters,  inckiding  Scliijf,^) 
Ehnnann,-)  Holzknecht'^)  and  the  author,')  would  appear 
much  more  tenable,  viz.:  that  we  have  here  mainly  an  eftect 
of  mechanical  irritation. 

It  has  often  been  observed  that  a  few  short  exposures  do 
not  cause  any  falling  of  the  hair,  but  rather  some  slight  irrita- 
tion which  may  lead  to  thicker  growth.  The  effect  is  quite 
analogous  to  that  produced  by  certain  chemical  agents 
(tr.  aconite,  veratria,  cantharides) ,  which  are  also  employed 
as  stimulants  to  the  scalp.  Probably,  however,  the  effect  of 
Roentgen-radiation  (and  also,  according  to  Finsen,  photo- 
therapy) is  more  penetrative,  and  therefore  more  likely  to  reach 
the  structures  concerned  with  hair-growth  than  is  the  case  with 
these  chemical  agents,  whose  effect  is  more  confined  to  the  sur- 
face of  the  skin.  We  know  that  under  certain  circumstances  alo- 
pecia areata  may  be  cured  also  by  other  physical  irritants.  Thus 
Ehnnann  shewed  this  with  faradisation.  If  this  view  be  cor- 
rect, the  X-ray  method  should  on  theoretical  grounds  possess  a 
certain  therapeutic  value  in  this  affection.  Undoubtedly  it  does, 
under  certain  conditions,  stimulate  the  process  of  hair-growth, 
though  it  is  an  open  question  if  the  origin  of  this  stimulus  is 
to  be  found  in  the  X-rays  themseWes  or  in  the  high-tension 
electricity  flowing  off  the  tube.  In  any  event,  to  obtain  this 
effect  it  is  not  necessary  (as  the  author's  experiments  prove)  to 
push  the  irradiation  in  the  first  instance  to  the  stage  of  epilation. 

The  property  which  Roentgen-radiation  possesses  of  stimu- 
lating hair-growth  is  by  no  means  so  reliable  as  its  action  as  a 
depilatory.  It  is  interesting,  however,  as  Kicnbock  remarks,  to 
note  that  identically  the  same  remedy  may  be  employed  to  pro- 
duce diametrically  opposite  results. 

Holzkncclit  tried  the  method  in  the  treatment  of  alopecia 
pityroides,  but  without  any  definite  success. 


')   IV  Intern,  rlcrmatolog.  Cong.,  Pari.s,  igoo. 
^)   Wiener  med.   Club,   30  January,   1901. 
')   L.  c. 

*)   Sitzun<;sb.  fl.  kais,  Akad.  d.  Wissensch.   in  Wien,  Matheni.-naUir.  cl., 
July  12.   1901,  Vol.  CIX,  Pan    ill,  p.  646. 


276  RADIO-THERAPY 

Hypertrichosis. 

The  methods  of  treating  this  skin  affection  are  in  the  main 
those  already  indicated  in  general  Roentgen-therapy.  Almost 
every  operator  has  his  own  technical-modifications,  which  he 
believes  to  be  the  best.  The  first  essential  is  to  become  thor- 
oughly acquainted  with  the  capacity  of  one's  apparatus;  it  is 
only  after  that  that  one  may  safely  introduce  niceties  of  detail. 

The  author  himself  uses  hard  tubes  showing  greenish  fluo- 
rescence in  a  non-darkened  room.  He  employs  a  30  cm.  coil 
and  currents  of  2  or  3  amperes  and  no  volts,  and  a  tube- 
distance  (skin  to  glass)  of  15  cm.  If  the  cheeks  and  chin  are 
to  be  exposed,  a  mask  is  used  which  covers  the  upper  part  of 
the  face  and  extends  to  the  edge  of  the  lower  lip.  The  chin  is 
irradiated  with  the  patient's  head  stretched  far  back,  and  at  the 
same  time  care  must  be  taken  to  protect  the  chest  with  a  leaden 
mask.  If  the  upper  lip  is  to  be  exposed,  a  mask  should  be  used 
covering  the  entire  face,  having  an  aperture  coinciding  with  the 
part  treated. 

Treatment  should  not  be  commenced  before  the  hairs  are 
long  enough  to  be  grasped,  and  the  patient  must  be  told  never 
to  pull  out  the  hairs  herself.  The  first  signs  of  skin-reaction  are 
usually  seen  after  20-25  sittings;  these  signs  have  already  been 
considered  at  length  (p.  255).  The  other  methods  of  irradia- 
tion were  also  described  in  detail  (pp.  250,  257,  258)  and  need 
not  here  be  repeated.  The  author  has  not  observed  any  differ- 
ences with  regard  to  the  reaction  of  blondes  and  brunettes. 
Occasionally  fine  lanugo  falls  more  readily  than  the  thicker 
medullated  hairs;  the  reverse  is,  however,  far  more  frequently 
the  case. 

The  later  course  of  the  reaction  is  as  follows :  After  a  few 
days,  during  which  the  earlier  signs  of  reaction  increase  in 
intensity,  the  hair  begins  to  fall  out  in  thick  tufts  when  lightly 
grasped,  or  it  is  seen  on  the  towel  after  the  patient's  toilet.  The 
hair-roots  are  thin  and  atrophied  (see  the  "Physiology  of 
Roentgen-radiation"),  the  skin  is  smooth  and  white,  and  the 
patient  often  feels  a  slight  burning  and  sensation  of  tension. 
These  signs  disappear  in  a  few  days  (5  to  8),  including  the 
sometimes  marked  pigmentation  (which  is  especially  seen  in  the 


.     TREATMENT  If  I  Til  X-RJYS  277 

case  of  brunettes),  and  the  skin  again  appears  cjuite  normal. 
If  no  further  treatment  he  aeiopted  tine  hairs  agani  make  their 
appearance  in  the  course  of  6-8  weeks;  these  grow  gradually  to 
their  former  size.')  If,  however,  after  4-6  weeks  (even  before 
there  are  the  slightest  signs  of  relapse)  a  brief  supplementary 
treatment  be  undertaken,  the  skin  will  preserve  its  good  appear- 
ance for  another  4  or  6  weeks,  after  which  period  the  process 
must  be  repeated.  In  this  way  the  treatment  must  be  kept  up 
for  12-18  months,  after  which  time  a  permanent  cure  may  be 
expected. 

The  author  has  had  already  a  large  experience,  which  war- 
rants him  in  saying  that  the  series  of  supplementary  courses  of 
treatment  as  indicated  above  turns  the  depilatory  effect  from  a 
transient  to  a  permanent  one.  He  bases  this  opinion  on  the 
repeated  examination  of  a  number  of  patients  since  their  final 
exposures  to  the  tube,  in  whom  not  the  slightest  signs  of  relapse 
were  evident. 

At  the  termination  of  the  sittings  the  skin  looks  plump  and 
well  nourished,  as  described  earlier  (p.  251).  After  a  few 
months,  however,  it  alters  somewhat  in  appearance,  the  change 
depending  solely  upon  the  extent  to  which  the  treatment  was 
pushed. 

The  final  effect  is  most  perfect  in  those  cases  in  which,  during 
the  whole  series  of  operations,  the  intensity  of  the  irradiation 
was  regulated  to  such  a  nicety  that  no  very  marked  changes 
were  visibly  produced  in  the  skin.  In  this  event  the  skin  appears 
quite  normal,  and  more  or  less  smooth  according  to  the  age  of 
the  patient.  In  the  site  of  the  follicles  one  finds  either  very  fine 
whitish  points,  which  disappear  after  a  time,  or  (in  places  which 
have  been  less  exposed  to  the  tube),  exceedingly  small  white 
lanugo-like  hairs;  the  latter  do  not  increase  in  size  and  are  prac- 
tically unnoticeable. 

Jutas5\  and  K.  Minirh  found  on  microscopic  exami- 
nation the  followmg  conditions  in  a  rabbit's  skin  which 


')    If  the  initial  course  of  treatment  was  more  energetic  relapse  will   take 
I)lace  mnch  later  — after  three  or  four  months. 


278  RADIO-THERAPY 

had  been  epilated  by  X-rays.^)    The  stratum  malpighii 
presents  a  straight  hne  bordering  the  cutis;  only  here  and 
there  can  a  hair-folHcle  be  seen.     These  follicles  pene- 
trate to  various  depths;  the  major  part  are  found  in  the 
superficial  layer  of  the  cutis.     They  possess  no  lumen; 
in  place  of  the  hairs  we  find  atrophied  epidermic  cells 
or  their  remains.     Some  of  the  follicles  penetrate  to  a 
deeper  layer  of  the  cutis;  in  these  thin,  black  hair-rests 
are  to  be  seen,  which  are  shrunken  from  the  papilla. 
The  papilla  pill  looks  atrophied,  and  consists  of  small, 
light-coloured  degenerated  cells.    The  hair-groups  which 
characterise  the  normal  skin  are  absent,  nor  can  their 
follicles  be  discovered.     In  place  of  the  latter  one  finds 
richly-cellular  connective  tissue.     Pigment  granules  are 
found  here  and  there  in  the  deeper  layers  of  the  cutis; 
in  this  region,  too,  the  blood-vessels  are  found  widely 
dilated  and  filled  with  blood-cells;  there  are,  however,  no 
thrombi.     No  abnormalities  can  be  found  in  the  larger 
nerves.     The  main  feature  Is  the  atrophy  of  the  follicles 
and  the  hair-papillae. 
If  during  the  course  of  treatment  the  signs  have  been  more 
severe — marked  Intumescence  and  erythema,  or  perhaps  slight 
excoriation — one    finds    changes    in    other    parts    besides    the 
follicles.     The  sites  of  the  latter  are  marked  by  small  scar-like 
depressions,  and  the  whole  of  the  irradiated  skin  appears  thinner 
and  more  wrinkled  than  is  natural.     The  wrinkles  may  not  be 
noticeable  while  the  facial  muscles  are  at  rest,  but  they  become 
quite  evident  when  the  patient  talks  or  laughs.") 

In  other  cases,  particularly  with  brunettes,  the  skin  remains 
darker  than  usual  for  some  months;  In  course  of  time  this 
excessive  pigmentation  disappears.  In  one  case,  that  of  a  fair- 
haired  girl  who  had  been  under  treatment  Intermittently  for 
15  months  for  hypertrichosis  of  the  forearms,  and  in  whom 
somewhat  marked  erythema  (without  excoriation)  had  thrice 
arisen,  a  reddish-brown  spotted  discolouration  remained  after 


')   Orvosi  Hetilap,  1898,  21-23. 

")    According  to  Ehrmann,  tlie  wrinkling  results   from  atrophy  of  small 
bundles  of  connective  tissue  in  the  skin. 


TREATMENT  JI'ITH  X-RAYS  279 

treatment  which  disappeared  very  slowly.  The  elephantiasis- 
or  sclerodermia-like  thickening  of  the  skin,  described  as  an  alter- 
eftect  of  Roentgen-radiation  by  many  writers  {Balzer  and  Mon- 
scaiix,  Salomon,  BartlicUmy,  Bchreiid,  liaUopcaii  and  Gadeait)^ 
has  not  as  yet  been  seen  by  the  author.  He  has,  however,  seen 
cases  treated  by  others  which  during  their  course  had  developed 
excoriations  and  ulcers.  The  scars  were  marked  by  extensive 
telangiectases  which  considerably  impaired  their  appearance,  the 
scars  themseh'es  being  smooth  and  otherwise  not  very  dis- 
figuring. 

Another  result  of  too  intense  and  too  frequent  expos- 
ure was  described  by  ./.  C  J oliiislcn.  ^)    \  medical  man, 
who  for  four  or  five  years  had  been  working  with  X-rays, 
observed  the  back  of  both  his  hands  to  be  going  red,  dry, 
slightly  scaly  and  somewhat  itching.     About  20  small 
tumours  developed,  varying  in  size  from  a  pin-head  to 
half  an  inch  in  diameter,   and   forming  hard,  shining, 
horny  elevations  which  were  depressed  in  the  centre  and 
surrounded  by  a  reddish  areola.    On  microscopic  exami- 
nation, these  proved  to  be  epithelial  accumulations.   The 
epidermis     was     considerably     thickened     throughout; 
moreover  there   were   large   masses   of  epithelial   cells 
lying  in  trabecular,  and  small  clusters  between  the  con- 
nective-tissue fibres.    J  oh  lis  I  on  regarded  the  condition  as 
one  of  those  keratoses  which,  like  leucoplakia  oris  or 
verruca  seborrhoeica,  are  considered  to  be  often  the  fore- 
runners of  carcinoma. 
Re\iewing  the  nchantagcs  and  disadvantages  of  this  treat- 
ment for  hypertrichosis,  we  find  we  have  here  one  of  the  most 
reliable  remedies  within  the  reach  of  the  medical  man,  inasmuch 
as  its  depilatory  effect  is  certain.    We  must  note  that  it  causes 
all  the  hairs — the  lanugo-hairs  as  well  as  the  thicker  ones — to 
fall;  that  large  areas  of  the  skin  can  be  treated  at  a  time;  that 
though  a  relatively  long  time  is  required  for  permanent  cure  the 
actual  sittings  occupy  but  a  brief  period,  so  that  the  patience 
and   endurance  of  patient  and  operator  arc   not  too  severely 


')   Pliiladtlpliia   Medical  Journal,   Feb.    i,   1902. 


28o  RADIO-THERAPY 

tried.  It  must  be  borne  in  mind,  moreover,  that  by  proceeding 
on  the  right  lines  in  the  first  instance  and  giving  supplementary 
sittings  as  they  are  required,  the  epilation  which  is  first  pro- 
duced may  be  made  permanent.  We  possess  in  the  Roentgen- 
treatment  an  absolutely  painless  method  of  epilation,  a  method 
which  enables  us  to  dispense  with  drugs,  dressings,  manipula- 
tions on  the  part  of  the  patient.  It  is,  morever,  one  which  does 
not  attract  attention  or  compel  the  patient  to  interrupt  her  usual 
avocations  or  social  intercourse. 

We  find  also  that  the  treatment  has  a  definitely  limited  dura- 
tion; it  matters  not  whether  a  small  area  of  skin  or  the  whole 
face  has  to  be  treated.  At  the  same  time  it  must  be  remem- 
bered that  under  certain  circumstances  changes  in  the  skin  occur 
which  cannot  be  considered  as  advantageous  to  the  complexion. 
It  is  possible  that,  with  increased  experience  and  ability,  we  may 
be  able  to  avoid  this  contingency  with  certainty;  nevertheless 
at  the  present  stage  of  our  knowledge  the  possibility  of  this  con- 
tingency is  one  which  must  be  put  to  the  patient  before  com- 
mencing treatment:  she  must  be  asked  whether  she  prefers  her 
hirsute  appearance  to  some  facial  wrinkles  which  may  develop 
after  treatment. 

Where  the  hairy  places  are  small  and  circumscribed,  the 
author,  in  common  with  Ehrmann  and  Schiff,  would  unhesitat- 
ingly advise  electrolysis.  Under  any  circumstances  it  would 
seem  advisable  to  avoid  visible  reaction  as  far  as  possible. 

Considering  the  numerous  undoubtedly  successful 
results  which  not  only  the  author  and  Schiff,  but  many 
Austrian,  German,  English,  American,  Hungarian  and 
Swedish  writers  report  {Griimnach,^)  Levy-Dorn,-) 
Groiiven;')  Hahn*)  Benedikt,^)  Sjogren  and  Seder- 
holm,'')      Sharpe,"')      Dumstrey,^)      Neville     Wood,^) 


Deutsche  med.   Wochenschr.,    1899,   27- 

Eulenburg's   "Real-Encyclopadie,"    Article    "Roentgenstrahlen." 

Niederrh.  Gesellsch.  f.  Natur-  u.  Heilk,  zu  Bonn,  Feb.  12,  1900. 

Aerztl.  Verein  in  Hamburg,  Nov.   19,  1900. 

Wiener  med.  Wochenschr.,  Nov.   19,   1900. 

Fortschr.,  Vol.  IV,  p.  163. 

Archives  of  the  Roentgen-rays,  Jan.  1901. 

Schmidt's  Jahrbiicher,  Vol.  CCLVI.         ")   The  Lancet,  Jan.  27,  1900. 


TREATMENT  fVITH  X-RAYS  281 

James  Startin,^)  Kienbock,-)  Jut  assy, ■")  Havas*) 
Ulhnaiin/')  Piisey^')  G.  H.  Lancashire,'')) — results 
some  of  which  have  been  demonstrated  and  acknowl- 
edged at  many  congresses  of  leading  dermatologists — 
the  objections  raised  by  Oudin  and  Bartlielemy  "*) 
against  the  Roentgen-treatment  of  hypertrichosis  seem 
hardly  justified.  These  writers  are  apparently  of  the 
opinion  that  internal  organs  may  be  injured  by  the 
process.  Probably  the  "visceral  accidents"  they  speak 
of,  and  which  they  ascribe  to  some  influence  on  the  sym- 
pathetic system,  are  to  be  explained  by  the  hysterical 
character  of  so  large  a  proportion  of  the  class  of  women 
who  would  resort  for  this  treatment  to  the  Paris  hos- 
pitals. 

Under  certain  circumstances  the  depilatory  effect  of 
the  Roentgen-rays  may  be  used  for  other  purposes.  Its 
application  in  this  respect  for  sycosis,  etc.,  has  already 
been  mentioned.  Gocht^)  reports  the  case  of  a  patient 
who  had  been  operated  upon  for  lymphadenoma  of  the 
neck.  The  edges  of  the  wound  became  folded  over,  and 
owing  to  the  irritation  caused  by  the  hairs  healing  was 
impossible.  Epilation  by  Roentgen-rays  resulted  in  per- 
fect healing  of  the  wound. 

2.    Ulcerations  and  skin-ajjections  leading  to  ulceration. 

Lupus  vulgaris. 

The  radio-therapy  of  lupus  has  received  the  greatest  atten- 
tion and  study  by  dermatologists.  A  really  certain  and  reliable 
remedy  for  this  most  serious  and  obstinate  disease  has  long  been 


The  Lancet,  March  .3,  1900,  and  Nov.  16,  1901. 

Wiener  nicd.  Club,  Feb.  6,   1900. 

L.  c. 

Festchr.  f.  Prof.  Kaf^osi. 

K.  k.  Gesellsch.  d.  Acrzte  in  Wicn,  Oct.  26,  1900. 

The  Journal  of  the  American  Medical  Association,  Sept.  28,  1901. 

Brit.  Med.  Journal,  May  31,  1902. 

La  Radiographie,  1900,  No.  39. 

Fortschr.,  Vol.  I,  Part  i,  p.  i?- 


282  RADIO-THERAPY 

a  desideratum;  the  affection  is  one  which  has  been  treated  for 
decades  past  with  no  altogether  satisfactory  results.  It  must 
still  be  left  an  open  question  whether  in  Roentgen-radiation  we 
have  attained  what  has  been  so  long  wished  for — a  specific  for 
lupus — and  if  the  treatment  will  supplant  all  other  methods. 

That  lupus  vulgaris  can  be  cured  by  X-rays  is  beyond  dis- 
pute; it  still  remains,  however,  to  be  proved  that  the  process 
is  easier  of  adoption  and  quicker  to  achieve  success  than  other 
methods.  The  author  is  of  opinion  that  the  advantage  of  the 
Roentgen  method  is  to  be  found :  ( i )  in  its  being  a  bloodless 
process;  (2)  in  its  excellent  cosmetic  results  (see  Figs.  80  and 
81).  As  regards  the  time  required  for  the  treatment,  this  is 
much  the  same  as  that  required  for  the  older  methods  or  for 
Finseu's  light-treatment. 

Just  as  in  the  Roentgen-treatment  of  hypertrichosis  vrc  have 
the  choice  of  two  schools.  1  he  one  deprecates  the  production 
of  dermatitis,  regarding  this  as  not  only  superfluous  but  as 
actually  injurious  and  retarding  the  cure  (Schijf,  Frcaud, 
Albcrs-Schonbcrg^,  Hahn,  Grouven,  Kihnmel) .  On  the  other 
hand,  the  opposite  school  recommends  the  deliberate  excitation 
of  powerful  reactions,  believing  that  in  this  way  a  scar  may  be 
obtained  of  good  appearance  and  free  from  relapse  for  a  con- 
siderable period  {Lion,  ScJwllz). 

The  technique  of  the  rival  methods  has  already  been 
described  in  this  work.  Suffice  it  to  note  here  that  by  one 
method  (with  hard  tubes  and  considerable  tube-distance)  a  com- 
paratively large  number  of  sittings  is  required,  whereas  with 
the  other  method  (soft  tubes  anci  shorter  tube-distance)  a 
smaller  number  of  sittings  has  the  effect  of  producing  very 
strong  reactions. 

The  usual  course  of  events  where  the  first  method  is  adopted 
is  as  follows :  the  first  signs  of  reaction  in  the  lesions  shew  them- 
selves in  the  form  of  an  alteration  in  their  colour.  They  become 
hyperaemic,  and  visible  nodules  become  dark-red;  at  the  same 
time  the  morbid  tissue  swells.  Later  on  the  visible  nodules 
break  down  and  often  necrose  entirely  away,  leaving  small, 
sharp-cut  ulcers  in  their  site.  The  whole  site  of  the  disease  may 
be  deeply  indurated,  and  neighboring  glands  enlarged.     The 


TREATMENT  U'lTII  X-R.nS 


28' 


ulcers  soon  heal,  lea\in^  sniall  scars.  These  scars  for  the  first 
few  weeks  may  present  a  perfectly  sound  antl  healthy  appear- 
ance, the  general  intumescence  and  tension  of  the  parts  having 
not  as  yet  subsided.  I'he  tuberculin-test  applied  at  this  stage, 
however,  proves  cure  to  be  incomplete  (Neisser,  Linn,  Srholtz), 
and  after  a  time,  when  the  swelling  has  subsided  and  the  tissues 
ha\e  again  become  lax,  more  deeply-seated  nodules  become  evi- 


FiG.  80. 


Fig.  81. 


Fig.  80. — Before  treatment. 

Fig.  81. — After  one  year's  iiitennittent  treatment  with  X-rays. 

dent.  After  a  few  weeks,  therefore,  the  treatment  requires  to 
be  repeated  again  and  again,  until  all  traces  of  disease  have 
finally  disappeared.  This  in  a  case  receiving  no  auxiliary  treat- 
ment may  take  a  year  or  more. 

It  is  worth  noting  that  after  a  fairly  prolonged  treat- 
ment with   X-rays  lupus  nodules  often   become  visible 


284  RADIO-THERAPY 

in  regions  which  had  hitherto  been  considered  healthy. 
The  rays  would  appear  to  have  an  elective  action  on  the 
lesions — a  peculiarity  which  was  demonstrated  by  the 
physicist  E.  P.  Thompson  to  exist  in  the  case  of  many 
substances  exposed  to  X-rays. 
The  other  method  has  for  its  object  the  destruction  of  the 
disease  "en  masse;"  it  may  be  regarded,  though  not  altogether 
correctly,  as  a  cauterisation  of  the  whole  lesion  by  means  of 
Roentgen-radiation.  The  method  is  certainly  more  radical, 
and  the  duration  of  the  actual  treatment  is  very  short.  Never- 
theless, it  is  very  questionable  if  the  patient  gains  any  advantage 
even  in  this  direction.  In  place  of  his  disease,  he  is  now  pro- 
vided with  an  ulcer  which  is  exceedingly  slow  in  healing  and  is, 
moreover,  excessively  painful;  thus  he  is  deprived  of  what 
should  be  the  chief  advantage  of  radio-therapy,  viz. :  its  pain- 
lessness. Sclioltz  has  shown  the  histological  changes  to  be  simi- 
lar whlche\  er  method  be  employed — molecular  destruction  of 
the  morbid  cell-growth,  reactive  inflammation  and  replacement 
of  the  lupus  tissue  by  connective  tissue.  But  the  whole  course 
of  reaction  is  much  milder  with  the  first  method,  the  patient 
is  spared  pain,  and  the  proceeding  is  more  conservative  of 
healthy  tissue;  whereas  with  the  more  drastic  method  the  wliole 
tissue,  healthv  and  diseased,  within  the  zone  of  irradiation 
becomes  necrosed  and  has  to  be  replaced  by  scar-tissue.  As  has 
been  pointed  out  earlier,  the  milder  method  requires  more  skill 
in  its  practice. 

Comparing  the  X-ray  treatment  of  lupus  with  Fiiisen's 
method,  it  must  be  noted  that  according  to  reports  published 
up  to  the  present  time  the  latter  shews  a  larger  percentage  of 
radical  cures. 

In  connection  with  this  point  it  may  be  observed  that 
up  to  now  Finsen' s  method  has  had  the  advantage  of 
being  carried  out  in  well-appointed  public  Institutions, 
on  a  properly  regulated  system.  Thanks  to  the  courtesy 
of  Hofrath  Prof.  ./.  Neinuauu,  the  author  has  now  the 
opportunity  of  treating  hospital  cases  also;  he  hopes  in 
due  course  to  be  able  to  supply  reliable  data  therefrom. 
Nevertheless  the  author  must  again  remark  that  by  the  aid 


TREATMENT  JVITH  X-RAYS  285 

of  the  Roentgen-treatment  he  has  succeeded  In  a  great  number 
of  cases  (sometimes,  it  is  true,  with  the  additional  help  of 
chemical  applications)  in  obtaining  radical  cures  of  lupus.  The 
scars  have  been  of  excellent  appearance,  moreover.  He  would 
advise  those  who  contemplate  the  practice  of  radio-therapy,  but 
whose  resources  are  limited,  to  purchase  an  X-ray  apparatus. 
Public  institutions  and  private  Individuals  who  can  afford  the 
outlay  should  certainly  possess  F'uiscn's  apparatus  as  well. 

In  case  the  Roentgen-treatment  of  lupus  be  decided  upon, 
one  should  undoubtedly  employ  the  milder  method  of  Its  appli- 
cation where  large  areas  of  disease  are  concerned.  Smaller  and 
more  circumscribed  lesions  may  be  destroyed,  too.  In  this  way, 
due  care  being  taken  to  protect  the  surrounding  healthy  parts 
with  leaden  masks.  In  these  cases,  however,  the  author's  own 
predilection  Is  in  fav^our  of  radical  excision  and  suture  or 
Thiersch's  method  of  transplantation. 

G.  H.  Lancashire  ^ )  recommends  the  X-ray  treatment  of 
lupus  where  ( i )  the  disease  Is  too  widespread  for  Finsen's 
treatment;  (2)  where  there  Is  much  ulceration;  (3)  where 
unsightly  scars  add  to  the  existing  disfigurement;  (4)  where 
the  mucous  membranes  are  involved. 

/.  Neumann  -)  believes  It  to  be  the  treatment  "par  excel- 
lence" for  "lupus  tumldus  et  exfoliatlvus"  of  the  face,  also  for 
the  hypertrophic  forms  involving  the  skin  and  sometimes  the 
fascia  and  muscles,  which  have  hitherto  been  considered 
incurable. 

Lupus  ulcerations  of  a  sluggish  character  assume  quite 
another  appearance  after  a  careful  series  of  irradiations; 
healthy  granulations  spring  up  and  cicatrisation  begins.  Lupus 
of  the  mucous  membranes  is  also  favourably  influenced.  The 
first  sign  of  reaction  in  these  cases  Is  increased  secretion;  thus  a 
patient  with  nasal  lesions  presents  the  symptoms  of  nasal 
catarrh.  Cavities  of  this  kind  may  be  irradiated  through  a 
leaden  tube  or  speculum,  the  skin  round  the  orifice  being  care- 
fully protected  by  a  leaden  mask. 


*)   British  Med.  Journal,  May  31,  1002. 

')  K.  k.  Gesellsch.  d.  Acrztc  in  Wicn.  Oct.  26,  1900. 


286  RADIO-THERAPY 

Himmel'^)  found  the  following  histological  appearances  in 
a  section  of  a  lupus  nodule  which  had  been  subjected  to  the 
rays: 

The  epithelium,  which  formed  a  thin  narrow  border  to  an 
apparently  homogeneous  mass,  was  perforated  by  small  aper- 
tures, the  size  of  which  did  not  exceed  the  diameter  of  a  cell- 
nucleus.  Nowhere  could  the  exact  outlines  of  the  individual 
epithelial  cells  be  made  out.  The  corium  appeared  shrunken. 
The  individual  bundles  of  connective  tissue  were  packed  closely 
together,  thickened,  and  translucent.  Elastic  fibres  could  not  be 
recognised.  In  stained  specimens  the  cells  of  the  connective 
tissue  appeared  shrunken;  they  took  the  stain  badly.  The  lupus 
growth  itself  appeared  greatly  changed.  The  giant-cells  were 
small ;  they  were  seen  as  small,  shrunken  homogeneous  bodies 
in  which  the  nuclei  were  but  faintly  indicated;  the  epithelioid 
cells  were  four  or  five  times  smaller  than  usual,  had  lost  their 
normal  shape,  were  homogeneous,  and  their  nuclei  did  not  stain. 
The  lymphoid  cells  had  become  transformed  also  into  small 
shapeless  bodies.  The  outlines  of  individual  cells  could 
often  not  be  distinguished,  they  being  so  closely  pressed 
together. 

The  general  microscopic  appearance  of  the  sections  suggested 
a  slow  necrotic  process  going  on  in  the  lupus  nodule,  the  epithe- 
lium, and  part  of  the  corium.  Hiieter  -)  found  that  the  tuber- 
cular tissue  gradually  underwent  a  fibrous  transformation.  A 
remarkable  feature  was  to  be  found  in  the  large  number  of 
giant-cells  present.  These  were  often  situated  eccentrically  or 
close  to  the  periphery  of  the  nodule;  many  nodules  seemed  to 
consist  almost  entirely  of  giant-cells.  The  zone  of  leucocytes 
bordering  the  tubercular  foci  was  very  narrow  or  entirely  absent. 
The  nodules  were  closely  encircled  by  bands  of  thick  connective 
tissue,  rich  in  nuclei.  The  line  of  demarcation  between  the 
morbid  growth  and  this  connective  tissue  was  sharply  pro- 
nounced.    No  tubercle  bacilli  were  seen. 


')   Archiv.  f.  Dermatologie  nnd  Syph.,  Vol.  L.  p.  335. 
^)   Quoted  by  Hahn  and  Alhcrs-Schonbcri^.   Mi'inchener  med.     Wochen- 
schr,  1900,  Nos.  9-1 1. 


TREATMENT  JJITII  X-RAYS  287 

Dr.  Groiiven,  whose  investigations  in  this  Held  are  most 
valuable,  reports  as  follows  ^ )  : 

"When  examining  with  low  powers,  we  are  struck  by  the 
abundance  of  connective  tissue  which  encapsules  the  several 
tubercular  foci  in  the  form  of  thick  bundles  of  fibre,  penetrating 
more  or  less  freely  the  interior  of  the  foci  themselves  (Fig.  82) , 
and  thus  forming  a  closehy  woven  network  enveloping  the 
residuum  of  the  morbid  growth.     The  spindle-cells,  which  are 


^ 


r—    ^.^  -^M  ■■-:-  ■        :^~>l:^|J'^4  ^>A 


Fig.  82.  Fig.  83. 

Fig.  82. — From  C.  Groiivcn.  "Histological  changes  in  lupus  tissue  after 
Roentgen  treatment."  Fortschr.  a.  d.  Gcb.  d.  Rocntgenstr.,  Vol  V, 
Part  3,  p.  186. 

Fig.  83. — A  giant-cell  enclosed  by  new-formed  connective  tissue,  highly  mag- 
nified.    From  C.  Grouven,  1.  c,  p.   187. 

present  in  great  numbers  (Fig.  83),  suggest  the  active  prolifera- 
tion of  connective  tissue.  Under  higher  powers  the  epithelioid 
and  lymphoid  cells  are  seen  to  be  greatly  degenerated;  this 
degeneration  is  shewn  by  the  poor  staining-properties  of  the 
nuclei,  disorganisation  of  the  nuclei,  and  vacuolisation  changes 
in  the  cell-protoplasm.  The  general  cbanges  are  analogous  to 
those  described  by  Gassmann  as  occurring  in  the  vessel-walls  of 
Roentgen-ulcers." 


')    Nicdcrrh.  Ges.  f.  Nat.  u.  Hcihv.,  Bonn,  June  17,   1901.    Fortschr.  a.  d 
G.  d.  Rocntg..  Vol.  V.  Part  i. 


2  88  RADIO-THERAPY 

Doiitrelepout  describes  the  process  of  healing  of  lupus  under 
Roentgen-treatment  as  follows : 

"The  first  eftect  of  irradiation  is  the  production  of  hyper- 
semia ;  this  leads  to  increased  migration  of  leucocytes  from  the 
vessels.  Just  as  in  the  tuberculin-reaction  the  infiltration  of  leu- 
cocytes begins  at  the  border  of  the  diseased  focus;  it,  however, 
penetrates  the  latter  also,  there  to  transform  itself  probably  into 
spindle-cells  and  fibrous  connective  tissue.  The  morbid  cells 
themselves  degenerate;  thus  we  get  a  gradual  absorption  of  the 
diseased  tissue  and  its  replacement  by  cicatricial  tissue." 

According  to  Sc/ioltz,^)  the  primary  effect  is  not  hyper- 
cemia,  leucocyte  infiltration,  and  fresh  formation  of  connective 
tissue,  the  secondary  one  being  destruction  of  lupus  nodules. 
He  believes  that  the  reverse  holds  good :  under  the  action  of 
Roentgen-radiation  we  have,  in  the  case  of  lupus,  first  a  degen- 
erative process  in  the  cell-elements,  especially  in  the  giant-  and 
epithelioid-cells  of  the  morbid  lesions  themselves;  this  is  followed 
by  inflammatory  reaction.  Scholtz  believes  the  healing  of  lupus  is 
mainly  brought  about  by  this  inflammatory  process,  that  in  conse- 
quence of  the  degeneration  in  the  morbid  cells  the  inflammatory 
reaction  is  directly  concentrated  upon  the  diseased  foci,  and  that 
we  have,  therefore,  to  deal  with  a  selective  effect  of  irradiation 
in  this  instance. 

Neisser^)  compares  the  effect  of  Roentgen-radiation  with 
the  tuberculin-reaction.  In  the  former,  however,  the  process  is 
a  slower  one,  and  is  attended  by  passive  hyperaemia.  By  this 
the  cicatricial  encapsulation,  and,  under  certain  conditions,  the 
absorption  and  destruction  of  the  tubercular  foci  is  effected. 
"Especially  in  the  case  of  Roentgen-dermatitis  one  can  see," 
says  this  author,'^)  "that  the  old  view  with  regard  to  inflamma- 
tory irritation  is  wrong,  and  that  fFeigert  was  correct  in  advanc- 
ing the  doctrine  that  in  all  these  processes  we  have  always  to 
deal  with  primary  tissue-lesions,  which  are  followed  by  inflam- 
matory reaction."     What  we  see  in  the  most  marked  forms  of 


')   Archiv.  f.   Dermatol,   u.   Syph.,  Vol.   LIX.   Part  3. 
-)  Ebstcin-Schwalbc's    Handbuch     der    prakt.     Med.,     Vol.     Ill     (Skin 
Diseases). 

^)   Quoted  by  Scholia,  p.  242. 


TREATMENT  JFITH  X-RAYS  289 

Roentgen-necrosis  takes  place  most  probably  also  in  those  milder 
alterations  in  which  actual  destruction  does  not  become  visible 
under  the  microscope. 

Many  writers  speak  of  good  results  with  this  treatment. 
The  first  report  in  this  field  came  from  Kiimmel  (26th 
Congr.  d.  deutsch.  chirurg.  Gesellschaft,  1897).  The  author, 
in  conjunction  with  Schiif,  treated  two  cases  on  which  he 
reported  at  the  12th  Internat.  Med.  Congress,  held  in  Mos- 
cow, and  which  Sc/iiff  mentioned  at  the  Naturforscherversamm- 
lung,  Braunschweig,  1897.  Further  reports  came  from 
Gocht^)  and  Albers-Schonberg^-)  followed  by  Sonnenhurg,^) 
Neisser,*)  v.  Ziemssen,^')  Gassmann  and  Schenkel,^)  Sten- 
beck,~)  Ch.  Schmid,'^)  GriinnujcJi,'')  Shcirpe,^'^)  Neivman,^'^) 
Hall-Edwards,^-)  Shole  field, ^^)  Rona,'^)  Jiitassy,^'')  Groii- 
ven,^'^)  J.  Neiimanu,^')  Himmcl,^'')  Lion,^'')  Schell,-")  Sjorgen 
&  SederJiolm,'^)    Clark    and   Smith,")    Pusey,-'^)    Geyser,-*) 


^)   Fortschr.  I,   i,  15. 

^)   Ibid.  I,  2  and  3;  II,  i,  23;  Miinchener  Med.  Woch.,  1900,  9-11. 

')   Freie  Vereinig.  d.  Chirurg.,  Berlins,  Jan.  10,  i8g8. 

*)   Schles.  Gesellsch.  f.  vaterl.  Cultur,  May  20,  1898. 

')  Aerztl.  Ver.  Munchcn.  June  8,  1898. 

')   Fortschr.,  II,  4,   i. 

')  Hygiea,  Vol.  LXI,  p.  568. 

*)   Fortschr.,  Ill,  i,  i. 

")   Deutsche  med.  Woch.,  1899.  No.  37. 

'")  The  Roentgen  Society  of  London,  Nov.  6,  1899.  Archives  of  the 
Roentgen  Rays,  Jan.  1901. 

")   The  Roentgen  Soc,  London,  Nov.  6,  1899. 

")   Edinburgh  Medical  Journal,  March,   1900. 

")   Brit.  Med.  Journal,  May  5,  1900. 

")   Konigl.  Gesellsch.  d.  Aerzte,  Budapest,  Nov.  9,  1899. 

'")   L.  c. 

")  L.  c. 

")   K.  k.  Gesellsch.  d.  Aerzte,  Oct.  26,  1900. 

^)  Archiv.  f.  Dermatol,  u.  Syph.,  Vol.  L,  p.  335. 

")  L.  c. 

")   Archiv.  d'electr.  medic,  experiment  et  clinic,   1900,  No.  96. 

")   Fort.schr.,  IV,  5,   I49- 

")   Buffalo  Med.  Journal.  Jan.,  1901. 

^)  The  Journal  of  the  American  Medical  Association,  Dec.  8,  1900,  and 
Sept.  28,    1 90 1. 

**)  Aerztegcselisch.,  New  York,  January,  1901. 


290  RADIO-THERAPY 

J  ones, ^)  Knox,-)  Lapinski,'^)  Kirmisson,'^)  Norman  Walker,^) 
Jadassohn,'^')  Van  Dort,')  Thurnwald,'^)  Jcney,^)  Du  Castel 
and  Foveaii  de  Coiirmelles,^'^)  J.  de  Nohele,^'^)  Stenbeck,^^) 
Holland,'')  P.  R.  Egau,'')  G.  H.  Lancashire,'')  G.  H.  Rad- 
man,''^')  J.  C.  Sqnance,''')  P.  A.  Morrow,'^)  and  others. 

Most  of  these  writers  agree  that  Roentgen-treatment  acts 
beneficially  in  the  case  of  lupus,  but  that  the  duration  of  the 
treatment  is  a  very  long  one,  and  that  it  is  advisable  to  combine 
this  method  with  others,  such  as  cauterisation,  scraping,  etc. 

Grouven  and  Aronstam  ^'')  reported  similar  good  results  in 
the  case  of  scrofulodermia. 

Ivar  Bagge  -°)  cured  tuberculous  ulcerations  which  had 
appeared  on  the  chest  in  the  site  of  old  cauterisation-scars  in  an 
elderly  man  by  means  of  X-rays.  The  rays  were  only  directed  on 
the  chest,  but  this  writer  reports  that  at  the  same  time  some 
ulcerations  existing  on  the  back  of  the  patient  also  healed. 

Sjogren  and  Sederholm  treated  5  cases  which  they  consid- 
ered to  be  of  the  nature  of  tuberculides  with  very  successful 
results.  (According  to  their  reports,  these  cases  seemed  to  par- 
take somewhat  of  the  nature  of  perniones,  or  to  suggest  lupus 
erythematosus.)    After  15-58  sittings  the  swelling  and  infiltra- 


^)   Philadelphia  Med.  Journal,  Jan.  6,  1900. 
")  Journal  of  the  American  Med.  Association,  Nov.  10,  igoo. 
')   Gazette  lekarska,  Vol.  XIX. 
*)   Soc.  de  Chirurgie,  Paris,  1898,  2,  11. 
^)  Lancet,  January,  1900. 

")   Encyclop.  d.   Haut-  und  Geschlechtskrankheiten,    1900. 
0  Tijdschr.  v.  Geneesk,  1900,  No.  18. 
')   K.  k.  Gesellsch.  d.  Aerzte,  Oct.  26,  1900. 

°)   Wissensch.  Verein  d.  Militaraerzte  der  Garnison,  Wien,  Jan.  26,  1901. 
")  Annales  d'electrobiologie,  1898,  Nov.  15. 
")   Ibid.  Vol.  Ill,  p.  236. 

^")   Quoted  by  Moellcr,  Der  Einfluss     des  Lichtes,  etc.,  Bibliothek.  med., 
121. 

")  Archives  of  the  Roentgen  Rays,  May,  1901. 
")  American  Medicine,  Nov.  16,  1900. 
'')   Brit.  Med.  Journal,  May  31,  1902,  p.  1329. 
")  Lancet,  Nov.  16,  1901. 
")   Ibid. 

*'*)   New  York  Dermatological  Society,  March  25,  1902. 
'")  Journal  of  Tuberculosis,  Oct.  1901. 
^)   Fortschr.  auf.  d.  Geb.  d.  Roentgenstr.,  Ill,  6,  p.  218. 


TREATMENT  If  IT  II  X-RAYS  291 

tion  receded  and  the  irritation  disappeared.     In  some  cases  there 
was  slight  atrophy  of  the  skin  left  afterwards. 


Epithelioma,  Ulcus   rodens. 

In  his  able  monograph  "On  the  Influence  of  Light  upon 
the  Skin,"  \vith  which  we  shall  deal  more  closely  in  the  next 
section,  Magnus  Moellcr  mentions  a  case  of  epithelioma  of  the 
face,  treated  by  Sjogren,  in  w^hich  Roentgen-radiation  had  a 
marvellously  good  effect.  The  illustration  bears  out  this 
impression.  Irradiation  with  hard  tubes  was  employed;  the 
current-strength  was  2.5-3  amperes,  and  the  tube-distance 
15  cm.,  the  duration  of  each  exposure  being  10  minutes.  After 
15  sittings  the  scabs  became  detached  and  the  ulceration  com- 
menced to  heal.  In  the  course  of  two  months  the  ulceration 
had  entirely  healed;  there  was  at  no  time  any  marked  reaction, 
and  the  skin  retained  an  almost  normal  appearance.  Later  on, 
however,  an  acute  dermatitis  set  in  on  the  eyelid  which  led 
to  ectropion  of  the  lower  lid.  Altogether  100  exposures  were 
given. 

Sequeira  ^)  reported  four  cases  of  ulcus  rodens,  the  diagno- 
sis of  which  had  been  microscopically  confirmed.  In  these 
Roentgen-radiation  had  given  excellent  results.  In  a  later  pub- 
lication-)  the  same  writer  reported  12  cases  of  the  same  dis- 
ease and  perforating  ulcer  treated  by  X-rays.  Five  of  these 
cases  were  cured,  but  of  their  permanency  the  writer  could  not 
at  that  time  speak.  In  a  third  report  (British  Medical  Associa- 
tion, Section  of  Dermatology,  Manchester,  1902),  Sequeira 
stated  that  he  had  indeed  observed  relapses  after  X-ray  treat- 
ment, but  that  these  were  In  turn  entirely  removed  by  further 
treatment.  Out  of  80  cases  of  rodent  ulcer  34  were  cured.  He 
believed  that  those  cases  w^ere  unsuitable  for  the  treatment  in 
which  bone  or  cartilage  are  Involved;  he  found  the  hard- 
growing  border  of  the  disease  resisted_  the  treatment  for  a 
long  time. 


')  Roentgen  Society  of  London,  Jan.  3,  190I. 
*)  Treatment,  March,  1901,  No.  i. 


292  RADIO-THERAPY 

Th.  Stenbeck^)  treated  2  cases  of  epithelioma  by  X-rays, 
exposures  being  given  daily  for  several  months.  Reaction  set 
in  after  8  days.  On  pressure  fairly  long  yellowish  plugs  could 
be  squeezed  from  the  diseased  area.  The  cases  healed  com- 
pletely and  without  relapse.  In  Stenbeck's  opinion  the  irradia- 
tion acts  electively. 

In  4  later  cases  Sjogren  ")  observed  after  25-33  sittings 
absorption  of  induration,  removal  of  scabs,  healing  of  ulcers, 
and  disappearance  of  subjective  phenomena,  such  as  pricking- 
sensations  and  tenderness.  The  skin  afterwards  looked  soft 
and  smooth  and  a  shade  darker  in  all  these  cases.  The  treat- 
ment was  carefully  carried  out,  reaction  being  avoided  as  far 
as  possible. 

Stenbcck  and  BoUeau  published  in  the  July  number  of  the 
Archives  d'electricite  medlcale  5  other  cases  of  malignant  dis- 
ease treated  in  this  way. 

In  a  report  published  in  the  73rd  Naturforscherversamm- 
lung,^)  Sjogren  advised  the  deliberate  induction  of  energetic 
reaction  so  that  necrosis  and  sloughing  of  the  morbid  tissue 
might  be  effected.  He  states  that  the  result  of  this  procedure 
is  to  leave  a  clean  open  wound  which  heals  with  a  clear  atrophic 
scar.  Of  the  cases  thus  treated  by  him  several  had  remained 
free  from  relapse  up  to  the  time  of  writing  (.>  to  i  year). 

Johnson  and  Merill*)  observed  in  5  cases  of  epithelioma 
that  Roentgen-radiation  diminished  suppuration  and,  after 
about  50  sittings,  brought  about  healing  almost  without  any 
visible  scar.  Both  operators  used  soft  tubes,  and  endeavoured 
to  produce  "Roentgen-burns"  (sic).  Chamberlain '')  obtained 
very  favourable  results  in  13  cases  of  carcinoma  of  the  skin  by 
means  of  hard  tubes  at  4-6  inches  distance,  6  minutes  expos- 
ures, and  sittings  held  daily,  or  later  twice  a  week.    This  author 


')   Congr.  internat.  d'Electrologic  et  dc  Radiologic  medicales,  Paris,  1900. 
Annales  d'electrob.,  Sept.,  Oct.,   1900. 
°)   Fortschr.,  IV,  4.  p.  166. 
')   Fortschr.,  V,  No.  i,  p.  38.  .    / 

*)   Philadelphia  Medical  Journal,   1900,  No.  8. 
°)   Journal  of  Electro-therapeutics,  New  York,  May.  1901. 


TREATMENT  Jl'ITH  X-RAYS  293 

recommends  for  X-ray  treatment  those  cases  In  which  there  are 
as  yet  no  signs  of  glandular  inv'olvement.  Other  good  results 
in  cases  of  carcinoma  were  reported  by  Smith,^)  JViUiains^-) 
Puscy;')  G.  B.  Ferguson,')  J.  B.  Lcvack;')  !.  F.  Rinchart;) 
If'alker,')  Morgan;)  Pugh;)  Morton;'')  Taylor;') 
Jf'iUiams;-)  and  Sclii^f ''') .  Pusey  observes  that  he  employed 
the  method  recommended  by  the  author  and  Scliilf 
(hard  tubes).  G.  H.  Lancashire  describes  the  course  of 
events  in  a  case  of  ulcus  rodens  treated  by  Roentgen-rays  as 
follows:  In  the  first  place  the  hard  border  of  the  growth 
becomes  softened,  the  neighbourhood  becomes  erythematous; 
the  wax-like  appearance  of  the  ulcer-base  gives  way  to  a  darker 
red,  its  smoothness  disappears  and  granulations  shew  on  the 
surface,  which  grow  apace.  In  course  of  time  the  base  of  the 
ulcer  becomes  level  with  the  surrounding  skin,  and  may  even 
reach  a  higher  level.  Gradually  new  epithelium  spreads  over 
the  ulcer  from  its  borders. 

On  the  w^hole,  from  the  comparatively  little  experience  so  far 
gained,  it  may  be  said  that  Roentgen-radiation  is  an  effective 
remedy  in  malignant  affections  of  the  skin  which  have  not 
already  involved  the  lymphatic  glands,  a  remedy  which  removes 
the  disease  at  any  rate  for  a  considerable  time,  and  gives  excel- 
lent cosmetic  results.  As  regards  the  question  of  the  intensity 
of  irradiation  which  should  be  applied,  the  remarks  already 
made  on  this  subject  when  dealing  with  lupus  will  apply  here 
with    equal    force.      Several    writers   {Sjogren,    Chamberlain, 


')  Philadelphia  Alcdical  Journal,  Dec.   i.  1900. 

')  Boston  M.  &  S.  Journal,  Jan.  17  and  April  4,  1901. 

')  The  Journal  of  the  American   Medical   Association,   Sept.   28,    1901. 

*)  Brit.  Med.  Journal,  Feb.  i,  1902. 

")  Scot.  Journal,  Feb.,  1902. 

")  Philadelphia  Med.  Journal,  Feb.  i,  1902. 

^)  Liverpool  Med.  Inst.,  April  17,  1902. 

")  Ibid.  Feb.  13,  1902. 

")  Brit.  Med.  Journal,  April  12,  1902. 

'")  Med.  News,  April  5,  1902. 

")  Brit.  Med.  Journal,  May  3,  1902,  and  Brit.  Med.  Assoc,  Manchester, 
1902. 

")  Ibid. 

")  K.  k.  Gesellschaft  dcr  Aerzte  in  Wicn,  Feb.  21,  1902. 


294  RADIO-THERAPY 

Piisey,  Schiff)  have  recorded  that  they  have  obtained  good 
results  with  the  milder  method — the  use  of  hard  tubes. 

For  several  weeks  preceding  the  publication  of  his  work 
the  author,  In  conjunction  with  Prof.  Ehrmann,  had  been  treat- 
ing a  case  of  carcinomatous  ulceration  of  the  soft  palate.  This 
was  in  a  patient  60  years  of  age,  and  the  diagnosis  had  been 
confirmed  by  means  of  the  microscope.  The  ulcer  was  the  size 
of  a  thaler  and  i  cm.  in  depth.  Its  borders  were  hard,  the 
base  coarsely  granulated  and  readily  bleeding.  There  was  con- 
siderable pain.  The  method  of  treatment  was  as  follows: 
The  patient  held  in  his  mouth  a  tube  lined  with  lead-foil,  one 
end  of  which  was  placed  over  the  ulcer.  The  face  was  pro- 
tected by  a  leaden  mask.  A  hard  tube  was  placed  opposite  the 
external  aperture  of  the  tube,  and  exposures  given  for  ten  min- 
utes daily.  After  the  seventh  exposure  the  borders  of  the  ulcer 
felt  considerably  softer,  and  its  size  had  decreased  centripetally 
to  that  of  a  kreuzer;  there  Avas  no  visible  reaction.  Moreover 
the  pains  had  been  relieved  and  the  swelling  of  the  lymphatic 
glands  had  been  strikingly  diminished. 

Scholtz^)  found  by  microscopic  examination  of  Roentgen- 
ised-carcinomata  that  the  malignant  cells  degenerated  and  were 
finally  destroyed  just  as  in  the  case  of  normal  epithelium.  One 
specimen  shewed  abundant  signs  of  commencing  mitosis. 

Mycosis  fungoides,  Lepra,  Sarcoma  of  the  Skin. 

Scholtz  describes  3  cases  of  mycosis  fungoides  in  which  an 
energetic  treatment  by  Roentgen-rays  was  followed  by  super- 
ficial necrotic  changes  leading  to  complete  disappearance  of  the 
morbid  lesions,  including  both  fully  developed  tumours  and 
pre-mycotic  foci.  Norman  fValker  and  H.  G.  Brooke  have  also 
reported  good  results  in  the  case  of  the  same  affection  ^).  One 
case  of  sarcoma  of  the  skin  was  also  favourably  influenced.  In 
two  cases  of  lepra,  however,  Scholtz  achieved  no  success;  de  la 
Camp's  experience  was  similar  '') . 


')  L.  c. 

°)   Brit.  Med.  Assoc,  Manchester,  July  30,  1902. 

')   Fortschritte,  Vol.  IV. 


TREATMENT  iriTIJ   X-R.nS  295 

Scholtz  examined  histologically  the  etiect  on  the  lepra 
lesions  by  Roentgen-radiation.  He  found  the  morbid  inliltratlon 
rather  less  in  the  regions  treated,  while  the  bacilli,  which  were 
abundantly  present,  were  slightly  more  granular  in  appearance 
than  elsewhere.  They  were,  however,  readily  stained,  and  had 
certainly  not  diminished  in  numbers.  Irradiation  had  therefore 
produced  practically  no  effect  on  the  pathogenic  micro-organ- 
isms. 

Chronic   ulcerations   of  various  kinds. 

Many  reports  have  been  published  which  shew  that  chronic 
ulcers  of  various  kinds  which  had  proved  partially  or  com- 
pletely refractory  to  other  methods  of  treatment  healed  readily 
under  X-rays.  Thus  Sjogreii  and  Sederhohn  ')  described  four 
cases  of  ulceration  (their  exact  nature  was  not  indicated)  in 
which  17  to  38  exposures  of  10  minutes  each  brought  about 
healing.     Weak  currents  were  employed. 

Colleville  -)  treated  varicose  ulcers  in  this  way,  and 
Sequcira  ^)  some  cases  of  perforating  ulcer.  Both  obtained 
successful  results.  Further  experience  in  this  branch  of 
Roentgen-therapy  is  much  to  be  desired. 

J.    Acute  and  clwonic  exiidcitive  DcrDuitilis,  cuid  grcninhit'wn- 

formations. 

Ilahn  and  Albers-Schonberg^)  found  that  Roentgen- 
radiation  in  the  case  of  chronic  and  acute  eczema  resulted  in 
diminution  of  the  discharge,  drying  of  the  skin,  relief  of  Itch- 
ing, and  removal  of  crusts  and  scales  after  comparatively  few 
exposures  -) .  Many  other  writers  confirmed  these  observations 
{Grunmach  •')    v.    Ziemssen,'')    Jutassy,')     S/iarpe,'')     Sjogren 


')  Fortschritte.  Vol.  IV,  No.  4,  p.  162. 

")  L'Union  med.  du  Nord-Est,  Aug.  30,   1897. 

')  Medical  Record,  1901. 

*)  Fortschritte,  Vol.  II,  No.   i.  pp.  16-24. 

')  Deutsche   mod.   Wochenschr.,   1899.  No.  ,^7. 

')  Congr.  f.  Inncrc  Mcdicin,  Wies1)adcn,   1898. 

')  Fortschritte,  Vol.  Ill,  No.  3,  P-  ii<^- 

')  Roentgen  Society  of  London,  Nov.  6,  1899. 


296  RADIO-THERAPY 

and  Scdcrholm,^)  Payne,^)  Scholtz;')  Schiff  *)  and  others). 
All  these  writers  stated  that  a  course  of  6-20  sittings  consider- 
ably relieved  the  trouble.  Sjogren  and  Sederholm  noted  espe- 
cially good  results  in  cases  associated  with  lichenification  and 
exudation. 

The  author's  own  experience  in  this  field  is  not  very  large. 
Up  to  the  present  time  he  has  seen  no  reason  to  abandon  the 
well-tried  treatment  of  eczema,  as  taught  by  the  Viennese 
school,  in  favour  of  Roentgen-therapy.  He  believes  that  no 
new  form  of  treatment  deserves  recognition  unless  it  proves 
effective  when  other  methods  hav^e  failed,  or  unless  it  does  bet- 
ter than  what  has  been  done  before.  Nevertheless,  he  has  tried 
the  Roentgen-treatment  in  some  cases  of  eczema  by  way  of 
experiment,  and  can  quite  confirm  the  opinions  of  Hahn  and 
Albers-Schonberg.  In  these  experiments  the  author  adopted  his 
usual  technique,  using  hard  tubes  at  a  good  tube-distance,  and 
suspending  operations  at  the  first  signs  of  reaction.  The  effect 
was  at  first  to  produce  diffuse  reddening,  slight  intumescence 
and  signs  of  desquamation.  In  two  cases  the  results  were  not 
permanent,  the  disease  afterwards  appearing  again.  In  a  case 
of  eczema,  with  tylosis  of  the  palm,  the  treatment  proved 
ineffective. 

Roentgen-treatment  for 

Psoriasis 

was  adopted  with  more  or  less  success  by  A Ibers-Schonberg,^) 
Grunmach,^)  v.  Ziemssen,')  Rubinstein,^)  Sharpe,^)  Payne,^^) 


Fortschritte,  Vol.  IV.  No.  5,  p.   175. 

Roentgen  Society  of  London,  Nov.  6,  li 

L.  c. 

Dermatologen-Congress,  Breslau,  1901. 

Fortschritte,  Vol.  II,  No.  4,  p.  141. 

L.  c. 

Aerzte  Verein  Miinchen.  June  8,  1898. 

Berliner  med.  Gesellsch.,  Nov.  8,  1899. 

L.  c. 

L.  c. 


TREATMENT  WITH   X-RAYS  297 

Groiivefi,^)  Halm,'-)  Sjoi^rcii  and  St'dcrliohu,'')  and  Scholtz*) . 
They  found  that  after  the  lirst  4  or  6  exposures  the  scaly 
plaques  fell  off  without  leaving  the  bright-red  points  character- 
istic of  psoriasis  (//<:?//;/,  Albers-Schoiiberir) .  Large  plaques 
must  be  exposed  at  a  considerable  tube-distance.  Exposures  are 
given  daily  for  the  lirst  two  or  three  times,  then  every  alternate 
day,  and  finally  every  third  day  (Sclioltz) .  The  author  himself 
recommends  treating  the  disease,  when  it  involves  a  large  sur- 
face of  the  body,  with  the  tube  at  30  cm.  distance,  giving  expos- 
ures of  10-12  minutes  each;  small  plaques  can  be  treated  at  a 
shorter  tube-distance  and  with  correspondingly  short  exposures. 
The  usual  course  of  events  is  as  follows: 

Should  there  be  any  very  red  plaques  present  they  become 
lighter  in  colour  after  three  or  four  sittings,  yellow-brown  pig- 
mentation collects  round  their  borders;  this  gradually  becomes 
darker,  reaching  finally  a  brown-black  shade.  The  scales  fall, 
hyperzemia  disappears,  and  the  pigmentation  spreads  still 
further.  The  latter,  however,  soon  disappears.  Scholtz's  experi- 
ence agreed  with  the  foregoing  in  most  cases.  Sometimes  the 
results  were  lasting;  In  other  cases  relapses  occurred.  Other 
observers,  on  the  other  hand,  report  relapse  to  be  the  rule  and 
state  that  It  often  actually  occurs  during  the  treatment. 

Scholtz  recommends  an  auxiliary  treatment  by  the  ordinary 
methods  on  the  termination  of  reaction  and  desquamation. 

Microscopical  examination  of  psoriasis-lesions  after 
exposure  to  X-rays  were  made  by  Scholtz.  He  found 
scarcely  more  than  the  ordinary  appearances  seen  in  the 
disease  itself.  The  prickle-cell  and  granular  layers  were 
deeper  than  normal,  and  slight  Infiltrations  were  still 
to  be  noted  on  the  papillary  body  and  round  the  sub- 
papillary  vessels.  The  epithelial  cells  shewed  the  same 
changes  which  are  found  in  normal  skin  exposed  to 
X-rays.  Peculiar  pigmentations  were  visible  In  the 
papillary  body  and  in  the  rete.    According  to  Scholtz, 


')  L.  c. 

')  FortschriUc,  Vol.  IV,  No.  5,  p.  9^^;  Vol.  V,  No.  i,  p.  39. 

•)  L.  c. 

*)  L.  c. 


298  RADIO-THERAPY 

the  situation  of  this  pigment  is  not  intercellular,  but 
rather  in  the  cell-walls  and  their  protoplasmic  sub- 
stances. 

Prurigo. 

Scholtz  treated  this  affection  also  to  X-rays  by  way  of  experi- 
ment, but  without  conspicuous  success.  On  the  other  hand  this 
observer,  also  Sjogren  and  Sederholm,  obtained  decidedly  bene- 
ficial results  in  cases  of  pruritus  ani  and  viilvw  after  very  few 
exposures  (6  Sjogren  and  Sederholm) .  From  the  few  accounts 
to  hand,  unfortunately,  the  benefit  does  not  appear  to  be  lasting. 

Scholtz  obtained  a  temporary  improvement  in  cases  of 
pemphigus  foliaceus.  In  a  case  of  lichen  ruber  planus  he 
obtained  striking  success ;  the  papules  were  absorbed,  the  process 
being  accompanied  by  desquamation  and  pigmentation. 

The  relief  of  pruritus  in  general  by  means  of  Roentgen- 
treatment  is  quite  comparable  to  that  obtained  by  d'arsonvalisa- 
tion.  It  should  be  borne  in  mind  that  the  presence  of  the  high- 
tension  electricity  accumulated  on  the  surface  of  a  Roentgen-tube 
in  action  is  quite  sufficient  In  itself  to  explain  the  relief  afforded 
in  the  cases  of  pruritus. 

Lupus   erythematosus. 

In  1898  E.  Schiff  treated  a  female  suffering  from  this 
affection  by  means  of  X-rays.  The  disease  took  the  common 
form  of  "butterfly-patch"  on  the  face,  and  for  purposes  of 
comparison  the  left  side  only  of  the  lesion  was  irradiated. 
Schif  observed '")  that  the  exposed  region  became  of  a  dark- 
red  colour;  scales  became  detached,  and  the  border  of  the  patch 
became  levelled.  Here  and  there  spots  varying  in  size  from  a 
pin-head  to  a  linseed  became  conspicuous  by  reason  of  their 
intense  red  colouring. 

In  course  of  time  the  infiltration  within  the  exposed  area 
entirely  disappeared,  the  skin  became  perfectly  smooth,  white, 
and  level.  The  sight  of  the  original  plaque  was  surrounded 
by  a  thin  ring  of  pigment.     The  further  course  of  events  in 


^)   Wiener  med.  Presse,  i8gQ,  No.  2. 


TREATMENT  JFITH  X-RAYS  igc) 

this  case  was  somewhat  remarkable,  as  described  In  a  report 
pubhshed  a  year  later  by  the  author  in  conjunction  with 
Schiff'). 

Some  little  time  after  apparent  healing  fresh  foci  of 
disease  appeared  round  the  original  site  in  the  shape  of 
prominent  reddish  lesions,  scaling,  and  with  plugged  fol- 
licles. The  hair  fell  from  the  left  temporal  region,  this 
part  having  come  within  the  X-ray  cone.  In  the  course  of 
the  next  few  weeks  the  secondary  lesions  disappeared, 
leaving  the  skin  white  and  smooth.  The  alopecia,  Iwiv- 
ever,  persisted.  The  appearance  of  permanent  alopecia 
after  a  single  course  of  irradiation  without  any  marked 
reaction  is  quite  unique.  The  author  can  only  explain 
this  circumstance  by  the  supposition  that  an  outbreak  of 
lupus  erythematosus  must  have  been  determined  in  the 
temple  itself,  since  this  disease,  as  is  well  known,  usually 
leads  to  permanent  loss  of  hair  when  affecting  the  scalp. 
There  were  distinct  evidences,  as  has  been  said,  of  fresh 
disease  in  the  immediate  neighbourhood  of  the  site  of 
the  original  disease.  These  were  probably  determined 
by  the  irradiations.  We  know  that  other  forms  of  irri- 
tants, such  as  caustics  (Kaposi),  will  often  provoke 
fresh  eruptions  of  lupus  erythematosus. 

In  the  treatment  of  this  case  extreme  caution  was 
employed;  any  marked  reaction  was  avoided  by  the  use 
of  hard  tubes, 
Sjogren  ")  proceeds  on  different  lines  in  his  Roentgen-treat- 
ment of  lupus  erythematosus.   His  object  is  to  provoke  a  strong 
reaction    (redness,   swelling,   exudation,   and  scab   formation). 
He    states    that    after    this    reaction    has    subsided    the    crustj^ 
fall,    leaving    an    atrophied    light-red    skin    which    shows    no 
traces  of  follicular  apertures.     Scliollz  adopts  the  same  pro- 
cedure. 

The    author,    in    company    with    Srliiff    and    many    others 


')   Bcitnigc    zur    Dcrmatologio    und    Syphilis.      I'cstsclirift    fiir    Ilofratli 
Neumann,  1900. 
')  L.  c. 


300  RADIO-THERAPY 

{ Jut  assy, ^)  Hahn,'-)  I.  Neumann,')  Gronven,*)  Llaberia,'') 
Lion,'')  SchoUz,'')  fFoods,^)  Taylor,'')  ),  has  found  that 
though  often  enough  satisfactory  results  have  been  obtained  in 
the  first  instance,  treatment  has  constantly  to  be  resumed  on 
account  of  ever-recurring  relapses.  By  very  prolonged  treat- 
ment in  many  cases  a  permanent  cure  may  be  attained.  The 
scars  are  then  smooth,  very  white,  and  level  with  the  surround- 
ing skin.  It  must  be  admitted,  however,  that  many  cases  are 
made  worse  by  the  treatment  {Neumann,  P.  S.  Abraham) . 

Acne   vulgaris,   rosacea   Furunculosis. 

Gautter  and  Pokitonoff  ^")  reported  in  1892  upon  17  cases 
of  acne  vulgaris  and  rosacea,  which  they  had  cured  after  daily 
exposures  of  ^-6  minutes  each.  They  used  currents  of 
4  amperes  and  18-20  volts,  and  a  tube-distance  of  30  cm.  After 
the  sixth  sitting  the  disease  began  to  diminish,  the  skin  became 
paler,  dilated  vessels  became  less  evident,  and  healthy  skin 
appeared  amongst  the  pustules  and  papules. 

K.  Ullmann's  ^^)  experience  in  a  case  of  obstinate  acne  of  the 
back  was  as  follows:  After  10-15  sittings  the  skin  became 
diffusely  reddened  and  the  papules  swollen ;  the  latter,  however, 
did  not  suppurate,  but  became  absorbed,  whilst  the  overlying 
skin  exfoliated.  The  disease  disappeared  completely  after 
50  sittings,  leaving  well-marked  pigmentation  behind. 

Hahn^~)  and  Jutassy^")  also  obtained  successful  results  in 
the  case  of  both  of  these  affections. 


^)  Fortschritte,  Vol.  Ill,  No.  3,  p.  119. 

')  Ibid.  IV,  2.  86. 

^)  K.  k.  Gesellsch.  d.  Aerzte,  Nov.  14,  1900. 

*)  L.  c. 

")  Fortschr.,  V,  i,  56. 

")  Dermatolog.  Congr.,  Brcslaii,  1901. 

')  L.  c. 

')  The  American  Journal  of  Alcd.  Sc,  Dec,  1901. 

°)  L.  c. 

^'')  Compt.  rend,  dii  XII.  Congr.  internal,  de  Medecine  Moscow,  Vol.  IV, 
pp.  382-386. 

")  Wiener  dermatol.  Gesellsch.,  Nov.  28,  1900. 

"")  Fortschr.,  Vol.  IV,  No.  2,  p.  96;  Vol.  V,  No.  i,  p.  39- 

")  L.  c. 


TREATMENT  JflTH  X-RAYS  301 

The  author's  own  experience  includes  i  case  of  rosacea 
and  2  cases  of  acne  vulgaris.  In  these  distinct  improvement 
was  brought  about  after  a  rather  long  period  of  treatment  with 
weak  irradiations.  Small  red  spots  persisted  for  some  time  in 
place  of  the  papules;  these  spots  afterwards  became  pigmented. 
In  one  case  of  acne  a  relapse  occurred  a  few  months  later.  The 
other  cases  were  only  recently  discharged,  so  that  nothing  can 
be  said  as  to  the  permanency  of  their  cure. 

In  a  case  of  chronic  iurunculosis  of  the  neck  the 
patient  was  relieved  of  the  trouble  for  a  considerable 
time  by  irradiation  pushed  to  the  stage  of  epilation. 
Torok  and  Schciii  explain  the  successful  action  of 
Roentgen-rays  in  affections  of  this  class,  on  one  hand, 
by  their  parasiticidal  qualities  (?),  and  on  the  other 
hand,  by  their  influence  on  the  sebaceous  glands,  in 
v.'hich,  as  in  the  sweat  glands,  the  secretion  is  dimin- 
ished^). In  the  author's  opinion  the  desquamation 
which  so  often  results  from  irradiation  is  the  most 
Important    factor. 

^.   Nwvus  jlammeus. 

Jiitassy  -)  claims  to  Have  cured  a  case  of  this  kind  after 
inducing  an  X-ray  dermatitis.  He  says  that  irradiation  pro- 
duces contraction,  thrombosis,  and  obliteration  of  the  vessels. 
In  the  Breslau-clinic,  however,  the  results  were  less  successful 
{Lion,    Schollz). 

In  conckision  we  may  mention  that  Sard  and  Sorcl  claim  to 
have  cured  a  case  of  elephantiasis-like  induration  of  the  hand, 
of  rapid  onset,  after  3  sittings  of  10-25  minutes  each''). 
Sjogren  and  Scderholm  cured  a  case  of  verrucae;  and  finally, 
other  operators  (Gocht  and  Scholtz)  cured  naevi  spili,  and 
Tori'ik  and  Schc'in  urticaria  pigmentosa  by  means  of  Roentgen- 
radiation. 


')  L.  c. 

^)   Fortschr.,  Vol.  TI,  No.  5,  p.  197. 

')  La  Normandic  Moflicak',  Feb.,  \i 


302  RADIO-THERAPY 

The   Treatment   of  Internal  Diseases  by  X-Rays. 

No  account  of  the  therapeutic  uses  of  X-rays  would  be  com- 
plete without  some  reference  to  the  facts  which  warrant  the 
employment  of  this  method  in  the  treatment  of  certain  internal 
disorders. 

Several  able  and  impartial  writers  have  already  furnished 
us  with  noteworthy  data  upon  this  subject.  Thus  Voigt^) 
mentions  a  case  of  pharyngeal  carcinoma  in  a  man,  set.  89,  in 
which  the  pain  was  relieved.  Gocht '-)  describes  2  cases  of 
inoperable  mammary  carcinoma  in  which  daily  irradiation  soon 
relieved  the  excruciating  neuralgic  pains,  without,  however, 
affecting  the  appearance  of  the  growth  in  any  way.  Johnson 
and  Merill^)  described  similar  results. 

The  author  himself  learned  from  a  private  communication 
which  he  received  from  an  eminent  surgeon  In  Vienna  that  a 
woman  suffering  from  metastic  carcinomatous  growths  In  the 
peritoneum  was  relieved  of  Intense  pain  by  the  X-ray  method; 
the  malignant  process  Itself  was,  however,  uninfluenced.  Clark 
states  that  in  a  case  of  ulcerated  carcinoma  of  the  breast  he  has 
seen  distinct  diminution  in  the  size  of  the  tumour  and  of  the 
auxiliary  glands  after  about  30  sittings  of  15  minutes  each*). 
Despeignes  ^)  relates  the  case  of  an  old  man  who  suffered  from 
cancer  of  the  stomach,  In  whom  "considerable  Improvement" 
took  place  after  80  sittings  held  twice  dally  for  ^-\  hour. 
P.  H.  Eifkman  ")  claims  that  he  has  cured  a  case  of  carcinoma 
of  the  breast,  and  we  learn  from  Dr.  IVeldor  of  New  York") 
that  John  G.  Oilman  of  Chicago  has  cured  50  cases  of  cancer 
by  means  of  X-rays.  Oiienisset  and  Segiiy  report  that  they 
obtained  improvement  In  a  case  of  recurring  and  metastatic 
sarcoma  ^).      C.  Beck  treated  a  recurring  sarcoma  of  the  lower 


^)   Aerztl.  Verein,  Hamburg,  Feb.  3,  1896. 
*)   Fortschr.,  Vol.  I,  No.  i. 
^)   Philadelphia  Med.  Journal,  No.  8,  1900. 
*)   Brit.  Med.  Journal,  No.  8,  1901. 
")  Lyon  Med.,  Dec.  20,  1896. 
")   Krebs  und  Roentgenstr.,  Harlem,  1902. 
')  Revue  des  Revues  cit.  "Wissen  f.  Alle,"  1902,  No.  i,  p.  14. 
*)   Quoted  by  Foveau  de    Courmelles,    Ann.    de    medecine    et    Chirurgie 
infantile,  Vol.  V,  No.  S,  p.  164. 


TREATMENT  iriTH  X-RAYS  303 

part  of  the  thigh  in  a  man,  a^t.  36,  by  exposure  given  2-3  times 
a  week  for  10-45  minutes.  He  accomphshed  a  "cure"  which 
lasted  for  9  weeks  {sic)  ^). 

The  writer  was  induced  by  a  Viennese  practitioner 
to  treat  an  inoperable  chondro-sarcoma  of  the  left 
parotid  gland  in  a  man  ait.  70.  Treatment  was  given 
daily  for  20  days,  using  hard  tubes  at  a  distance  of 
15  cm.,  for  6-8  minutes.  Results  were  entirely  nega- 
tive. 

A  similar  case  treated  by  a  colleague  proved  equally 
unsuccessful. 
Another  property  of  Roentgen-radiation  which  has  already 
been  referred  to,  viz.,  its  analgesic  effect,  suggested  its  employ- 
ment in  painful  affections  generally.  Stembo  -)  succeeded  in 
relieving  21  out  of  28  cases  of  neuralgia,  giving  from  3  to  10 
sittings  of  about  5  minutes  each.  The  author  has  himself  proved 
experimentally  that  analgesic  properties  of  X-rays  are  not  to  be 
ascribed  to  suggestion-effects,  since  with  the  current  reversed  no 
improvement  can  be  obtained.  The  true  explanation  is  to  be 
found,  he  believes,  in  the  electrical  stimulation  of  the  peripheral 
sensory  nerves,  which  inhibits  the  functions  of  deeper-lying 
nerves  and  so  relieves  the  neuralgia. 

The  author  succeeded  in  the  case  of  an  old  man  who 
suffered  from  a  trigeminal  neuralgia,  which  was  scarcely 
relieved  even  with  morphia,  in  bringing  about  marked 
improvement   after    11    sittings;   there   was   no   visible 
reaction    in    this    case.      In    a   second    case    irradiation 
proved    unsuccessful. 
Griinmdch  ")  employed  Roentgen-therapy  with  varying  suc- 
cess in  cases  of  neuralgia  of  the  face,  occiput,  and  intercostal 
nerves,  and  in  articular  and  muscular  rheumatism.    Soiillig^atc 
Lcia^li  ')   reported  before  the  Seabord  Medical  Society  the  case 
of  a  patient  who  had  been  shot  in  the  upper  part  of  the  thigh, 
who  complained  of  pain  in  the  knee-joint.  The  pain  disappeared 


')  Munchcncr  mcd.  Wnch.,  1901,  No.  32. 

*)  D.  Tlicrapic  d.  Gegcnw..    1900,   No.  6. 

')  Deutsche  mod.  Woch.,   1899,  No.  37- 

*)  The  American  X-ray  Journal,  Vol.  IV,  April,  1899. 


304  RADIO-THERAPY 

ilfter  an  exposure  lasting  4  hours.     In  another  case  irradiation 
is  said  to  have  removed  colic  due  to  biliary  calculi. 

Rheumatic  and  tuberculous  joint-altections  are  said  to  have 
been  improved  by  Roentgen-radiation.  Sokolozu  treated  acute 
and  chronic  rheumatism  in  children's  joints  by  covering  the 
diseased  parts  with  Avoollen  blankets  and  exposing  them  for 
10-20  minutes  at  a  tube-distance  of  50-60  cm.  He  states  that 
after  1-4  sittings  the  pains  disappeared,  the  swelling  perceptibly 
diminished,  and  the  mobility  of  the  limb  improved  ^). 

According  to  Southgate  Leigh,  a  tubercular  elbow-joint  was 
completely  cured  by  2-hour  exposures,  administered  two  or  three 
times  a  week, 

Kirmisson  states  -)  that  he  much  improved  a  tubercular 
wrist-joint  affection,  in  a  girl  of  14,  in  65  sittings  lasting 
10  minutes  each.  Similar  reports  come  from  Bazy,  Lancaster, 
Sainton  ^)  and  Escherich  *). 

Even  pulmonary  tuberculosis  and  acute  inflammation  within 
the  chest  are  stated  to  have  been  cured  by  some  authors 
(according  to  Rendu  and  du  Castel/')  by  Roentgen-treatment; 
Bergonie  and  Alongoiir,''')  Sinapius,'^)  Chanteloube,  Dcscamps 
and  Rouillies,^)  Destot  and  Dubard  "') .  Aitsset  and  Bedard  ^^) 
report  on  a  case  of  chronic  tubercular  peritonitis.  After  50  sit- 
tings given  daily  for  ^  hour,  employing  powerful  tubes  at  a 
distance  of  20-23  cm.,  the  ascites  disappeared,  likewise  the  hard 
irregular  masses  which  had  previously  been  felt  through  the 
abdominal  walls,  and  the  general  condition  of  the  patient 
improved.  Two  years  later  these  writers  reported  a  similar 
case.     In  conclusion  we  may  mention  that  PauUn  Mery  and 


zig.  I 


Wratsch,  1897,  No.  46. 

Soc.  de  Chirurgie,  Feb.  2,  1898. 

Quoted  by    Bergonie,  La  sem.   med.,    1898,  p.   349. 

Revue  mensuelle  des  maladies  de  I'enfancc,  May,   1898. 

Soc.  med.  des  Hopitaux,  Jan.  15,  1897. 

Acad,  de    medecine,  July,   1897. 

Die  Heilung  der  Lungentuberculose  durch  Roentgcnbestrahlung,  Leip- 

897. 
Arch,  d'electric.  med..  May  15,  1897. 
Gazette  des  Hopitaux,  Aug.  13,  1898. 
Echo  med.  du  Nord,  1898,  No.  461. 


TREA  TMEN  T  JVI TH  X-RA  YS  305 

Campcuou  ^)  are  said  to  ha\e  hastened  the  union  of  a  fractured 
bone,  and  A.  de  Laucastrc'-)  to  have  cured  a  case  of  suppurat- 
ing osteo-periostitis  by  means  of  Roentgen-radiation. 

The  author  has  but  little  to  contribute  with  regard 
to  this  particular  department  of  Roentgen-therapy;  he 
has  seen  practically  no  physiological  or  therapeutic 
effect  which  could  be  ascribed  to  the  influence  of  the 
rays  upon  internal  organs.  Nevertheless  he  is  not  pre- 
pared to  deny  the  possibility  of  such  an  effect  existing; 
he  believes  that  Kienhbck  •')  goes  too  far  when  he  says 
that  X-rays  can  only  produce  deep-lying  changes  when 
an  ulcer  is  first  formed.  There  may  be  rays  of  another 
kind  from  the  tube  which  influence  tissues  other  than 
the  skin. 

§  32.  Physiological  Effects  of  X-Rays. 

Soon  after  the  publication  of  Roentgen's  discovery  it  became 
known  that  his  rays  have  a  definite  influence  upon  the  proto- 
plasm of  living  tissues.  Investigations  were  duly  made,  with 
the  following  results : 

The  chief  objects  of  enquiry  were  as  follows: 

1.  The  influence  of  Roentgen-rays  upon  the  higher  organ- 
isms, upon  certain  regions  and  their  functions. 

2.  The  histological  changes  in  the  cells. 

3.  The  mfluence  of  the  rays  upon  bacteria. 

4.  Their  action  upon  the  plasmodial  activity  of  various  low 
forms  of  life. 

As  regards  i,  there  is  little  to  be  added  to  what  has  been 
already  stated  in  the  previous  section.  Capranica*)  observed 
that  moles  exposed  to  Roentgen-rays  are  excited  for  several 
hours  afterwards,  but  that  no  alteration  could  be  noted  in  the 
amount  of  carbonic  acid  they  excreted. 


')    Quoted    by    Fuvcau   dc   Counndlcs,   Ann.   dr   im'd.   v{    Cliirnr^;.,    i')"i. 
No.  5,  p.   164. 

')    RcvisUi  pfjrtuguc/.a  dc  medic,  c.   cirurKia  pralicus,   Nov.,    1897. 

")   \Vr.  mcd.  Prcsse,  igoi.  No.  19. 

';  I'rumclhciis,  Wochenschr.,  1896,  p.  717. 


3o6  RADIO-THERAPY 

On  the  other  hd.nd,Tnrkha}iojf  ^)  states  that  frogs  whose 
cerebra  have  been  exposed  to  the  rays  sustain  a  loss  of  reflex- 
sensibihty.  After  replacing  the  creatures  in  water  their  skin 
remains  very  dark-coloured,  and  only  regains  its  lighter  hue 
after  several  hours. 

Gaston  Scguy  and  F.  Quenisset'-)  noted  that  after  they 
themselves  had  been  exposed  to  the  rays  for  a  long  time  they 
suffered  from  violent  and  irregular  cardiac  palpitation.  A 
female  patient  also  who  had  been  under  treatment  complained 
of  the  same  trouble,  coupled  with  a  feeling  of  oppression. 

Sabrazcs  and  Rhicrc  ^)  carefully  examined  the  heart's  action 
in  cold-blooded  animals  (frogs)  after  Roentgen-radiation. 
They  could  observe  no  change  in  cardiac  rhythm  even  after  pro- 
longed exposures. 

Destot^)  watched  the  pulse  while  the  hand  was  being  irra- 
diated by  a  vacuum-tube  worked  from  a  static  apparatus,  and 
afterwards  from  a  coil.  The  exposure  on  each  occasion  lasted 
one  hour,  the  tube-distance  being  5  cm.  A  pulse-tracing  was 
taken  by  a  Marey  sphygmograph.  7  he  static  machine  caused 
the  disappearance  of  the  dicrotic  wave  after  10  minutes;  the 
whole  curve  became  higher,  but  the  rate  of  pulsation  was  not 
affected.  When  the  coil  was  used  to  work  the  tube  the  pulse 
shewed  at  first  a  higher  tension.  This,  however,  soon  fell, 
and  was  succeeded  by  arhythmla  and  intermittent  pulsation. 
In  both  cases  the  radiation  was  of  like  intenstiy.  Destot 
concludes  that  the  cause  of  the  physiological  disturbances 
observed  in  Roentgen-radiation  is  to  be  found  in  the  effect  upon 
the  sensory  nerves;  these  affect  the  spinal  cord,  and,  in  a  reflex 
manner,  the  vascular  system. 

L.  Lecerde^")  irradiated  the  shaven  posterior  regions  of 
rabbits,  anci  observed  the  temperature  of  the  skin  and  rectum 
both  before  and  after  the  experiment.  (The  time  of  exposure 
is  not  stated.)     The  first  effect  was  a  fall  in  the  temperature; 


^)  Gaz.  Botkin,  32. 

^)  Compt.  rend,  de  I'Acad.  de  Sc,  Vol.  CXXIV,  p.  790. 

')  Ibid.  p.  981. 

*)  Compt.  rend.,  Vol.  CXXIV,  p.  11 15. 

°)  Compt.  rend.  Acad.,  Vol.  CXXV,  p.  234. 


TREATMEXT  JJITII  X-RAYS  307 

this  was  soon  followed  by  a  rise  to  above  normal.  The  same 
observer  found  ^)  that  the  animal's  skin  parted  with  more  heat 
after  irradiation,  and  this  phenomenon  was  maintained  for  a 
considerable  time.  In  a  later  publication  Eecercle  '-)  states  that 
the  function  of  perspiration  in  rabbits  becomes  temporarily 
impaired  by  exposure  to  the  rays.  In  yet  another  series  of 
experiments  it  was  shewn  that  exposure  on  3  successive  days 
caused  increased  excretion  of  phosphates  in  the  urine,  which 
change  was  maintained  for  a  couple  of  days. 

Several  writers  argued  from  certain  clinical  phenomena 
(headache,  insomnia,  difficulty  in  micturition,  menstruation, 
etc.),  which  appeared  occasionally  after  irradiation,  that  the 
rays  had  some  influence  upon  internal  organs.  Thus  Oiidin, 
Barthelemy  and  Darier'')  observed  that  irradiation  with  too 
powerful  a  current,  or  with  certain  other  kinds  of  defective 
technique,  resulted  in  gastro-intestlnal  disturbances,  palpita- 
tation,   etc. 

In  a  later  publication  *)  these  authors  described  "visceral 
complications"  as  occurring  after  radio-therapy  in  cases  where 
there  were  no  actual  signs  of  gastric-disorder.  They  refer  these 
phenomena  to  a  disturbance  of  the  sympathetic  system.  (They 
would  seem  to  overlook  the  fact  that  in  emotional  people  these 
occurrences  not  uncommonly  result  from  any  kind  of  psychic 
disturbance.)  Amongst  the  many  thousand  Roentgen  opera- 
tions which  the  author  has  conducted  for  the  past  six  years  he 
has,  however,  met  with  no  such  case  of  "visceral  complication." 
The  trembling  and  disturbances  of  sensation  which  Oiidiii  men- 
tions as  occurring  on  the  hands  of  those  who  work  with  X-rays 
are  not  to  be  explained  in  this  way.  The  trembling  may,  of 
course,  be  due  to  very  different  causes;  the  sensory  disorders 
may  result  from  the  dermatitis  which  careless  operators  often 
contract. 

jralsh  '')  also  describes  complication  similar  to  those  men- 


')  Compt.  rend.  Acad.,   Vol.   CXXV,   p.   583- 

')  Compt.  rend..  1896,  Vol.  II,  p.  362. 

')  Monatsch.   f.  prakt.   Dermatologie.  Vol.  25,  No.  29. 

*)  La  Radiographic,   1900,  Vol.  IV,  No.  39. 

■')  Brit.  Med.  Journal.   1H97.  p.    1905. 


3o8  RADIO-THERAPY 

tioned  by  Oudin  and  Barthelemy.  He  has  seen  effects  like  those 
of  sunstroke,  also  gastric  disturbances. 

Rodet  and  Berthin  ^)  after  exposing  animals  to  intense  irra- 
diation produced  dermatitis,  paralysis,  and  convulsions  followed 
by  death.  They  found  at  the  autopsy  meningomyelitis  (thick- 
ening and  adhesions  of  the  meninges,  congestion  of  the  spinal 
cord,  cell-hyperplasia  and  small  haemorrhages),  which  was  evi- 
dently not  due  to  sepsis;  bacteriological  examination  of  the 
blood,  peritoneal  fluid,  and  spinal  cord  giving  negative  results. 

Scholtz  found  on  making  enquiries  into  the  effect  of  irradia- 
tion upon  internal  organs  that  ev^en  intense  exposure,  such  as 
leads  to  necrosis  of  the  tissues,  causes  no  evident  signs  of  mis- 
chief along  the  gastro-intestinal  tract.  Young  animals,  whose 
anterior  fontanelles  had  not  yet  closed,  died  sometimes  with 
paralytic  symptoms,  and  sometimes  without  any  definite  symp- 
toms at  all,  after  their  crania  had  been  exposed  to  the  rays. 
Several  other  observers  state  that  small  animals,  such  as  guinea- 
pigs,  suffer  from  paralysis  after  irradiation  of  the  occipital 
region ;  sometimes  sudden  death  ensues.  Considering  the  thin- 
ness of  the  skin  and  bones  In  these  cases,  one  can  readily  under- 
stand the  possibility  of  the  rays  penetrating  to  the  central  nerv- 
ous organs  and  so  producing  dangerous  or  fatal  lesions.  It  is 
known  that  high-tension  electricity  has  an  unfavourable  Influ- 
ence upon  small  animals.  (See  the  author's  experiments,  pp.  121, 

145'   I74-) 

Intense  Irradiation  of  a  rabbit's  eye  has  produced  necrosis 
in  the  neighbourhood  of  the  eyeball,  but  no  Important  changes 
in  the  eye  itself. 

Investigators  have  for  some  time  been  concerned  with  the 
question  as  to  whether  Roentgen-rays  are  visible,  or  whether 
they  exert  any  effect  upon  the  retina  or  other  structures  of  the 
eye.  Several  observers  have  assumed  that  the  retina  is  sensitive 
to  Roentgen-rays.  Thus  Axenfeld-)  came  to  this  conclusion 
after  some  experiments  he  made  upon  arthropedes.  He  placed 
the  animals  In  a  box  made  of  half  wood  and  half  lead,  and 


')  Gazette  des  Hopitaux,  May  7,  1898. 

')   Centralbl.  f.  Physiologic,  X.  No.  6,  p.  147  and  No.  15,  p.  436. 


TREATMENT  WITH  X-RAYS  309 

exposed  this  box  to  the  rays;  the  animals  all  moved  to  the 
wooden  portion.  Blinded  animals  did  not  act  in  this  manner. 
Braiides^)  made  an  experiment  to  see  if  aphakic  persons  are 
sensitive  to  the  rays.  A  girl,  both  of  whose  lenses  had  been 
removed,  received  an  impression  of  light  from  a  Crookes  tube 
which  had  been  previously  covered  with  a  dark  cloth. 

Brandes  also  believed  he  received  a  visual  impression  from 
Roentgen-rays  after  covering  both  his  eyes  with  leaden  masks; 
he  believed  that  the  rays  gained  entrance  round  the  masks 
(which  were  shaped  like  spectacles) ,  though  they  did  not  appear 
to  traverse  a  central  aperture  which  had  been  made  in  the 
masks  themselves ") . 

This  observation  was  disputed  later  by  Radigiict  and 
Guichand,'')  also  by  Darieix^) .  Chalpiiccky  found  that  only 
apertures  above  4  mm.  allowed  the  passage  of  perceptible  rays. 
The  rays,  moreover,  were  only  effective  in  the  periphery  of  the 
visual  field;  the  central  part  of  the  lens  would  appear  to  be 
opaque  to  them,  and  this  probably  explains  why  radiograms  of 
the  lens  give  shadows  almost  as  dense  as  those  of  the  whole  eye- 
ball. G.  Bardet/')  to  some  extent,  confirms  Brandes'  experience; 
he  believes  that  any  one  within  the  zone  of  action  of  a  vacuum- 
tube  receives  an  impression  of  light.  For  this,  however,  it  is 
essential  that  the  room  be  absolutely  dark  and  that  there  be  no 
colours  on  the  walls,  since  many  colours  fluoresce  on  exposure 
to  X-rays.  Bardet  finds  that  the  eye  placed  a  few  centimetres 
in  front  of  a  covered  vacuum-tube  in  action  receives  just  such  a 
feeble  impression  of  light  as  is  produced  by  moving  a  lighted 
candle  before  the  closed  lids.  When  the  apparatus  stops  work- 
ing this  impression  disappears,  and  the  same  happens  if  a  screen 
of  iron,  copper,  or  lead  be  interposed.  A  glass  screen,  however, 
diminishes  the  effect  but  little,  an  aluminium  screen  not  at  all. 
If  the  tube  be  turned  on  its  axis  through  180'',  so  that  the 
cathode-rays  strike  the  side  of  the  tube  which  is  furthest  from 


')  Sitzungsb.    d.    Preuss.  Akad.  d.  Wiss.   1896.  p.  547. 

*)  Quoted  by  Gcbhardt,  Die  Ileilkraft  dcs  Lichtcs,  Leipzig,   1898,  p.  278. 

')  Acad.  d.  Medec.  Nov.  16,  1897. 

*)  Quoted  by  G.  Bardet. 

•)  Compt.  rend,  dc  I'Acad.  dc  So.,  Vol.  CXXIV.  p.  1388. 


3IO  RADIO-THERJPY 

the  eye,  no  light  impression  is  received,  showing  that  the  "elec- 
tric field"  can  have  no  share  in  this  phenomenon. 

Foveau  de  Courmelles  ')  examined  204  blind  children.     He 
found  that  only  9  of  these  received  any  impression  of  light  from 

X-rays. 

It  has  long  been  known  that  electric  currents  and 
discharges  applied  to  the  eye  cause  a  sensation  of  light. 
Purkinje  ^)  produced  this  sensation  by  the  electric  stimu- 
lation of  the  retina  and  optic  nerves. 

G.  E.  Mailer^)  found  that  a  constant  electric  cur- 
rent sent  through  the  retina  in  an  afferent  direction  pro- 
duces on  "closing"  a  light  blue-violet  sensation;  appHed 
in  the  reverse  direction,  however,  there  is  a  sensation  of 
dark  yellowish  green.  On  opening  the  circuit,  the 
reverse  takes  place.  Daricr*)  found  that  in  cases  of 
amblyopia,  without  nerve-lesion,  a  sensation  of  light  is 
induced  by  very  feeble  currents;  where,  however,  there 
is  atrophy  of  the  optic  nerve  far  stronger  currents  are 
required. 

D'ArsonvaV')   shewed  that  the  eye  receives  a  quite 
similar  impression  of  light  when  brought  into  an  electro- 
magnetic field  produced  by   an  alternating  current  of 
42  periods.      (Recently  Berthold  Beer'')  has  pubHshed 
observations  to  the  same  effect.)      D'Arsonval  empha- 
sises the  fact  that  a  magnetic  field  acts  like  other  physio- 
logical irritants,  not  by  virtue  of  its  intensity  alone  but 
by  its  alternations. 
In  variance  with  the  above  testimony,  which  speaks  for 
some  influence  upon  the  eye  by  Roentgen-radiation,  the  experi- 
ments of  Fuchs,  Krcidls  ')  and  Gatti-)  w^ould  seem  to  indicate 

')   Compt.  rend,  de  I'Acad.  de  Sc,  Vol.  CXXVI.  p.  QiQ- 

')   Briicke,  Vorlesungen  iiber  Physiologic,  Vol.  II,  p.  919. 

')   Zeitschr.  f.  Psychologic  und  Physiologic  dcr  Sinnesorgane,  Vol.  XIV. 

P-  329- 

*)   Bull,  de  la  soc.  frang.,  d'ophtha.,  83,  quoted  by  Nagcl,  Jahresubcrsicht. 

1884,  p.  242. 

»)  Compt.    rend,    de  I'Acad.  de  Sc,  Vol.  CXXIV,  p.  1389- 

')   K.  k.  Ges.  d.  Aerzte,  Wien,  Jan.  17,  1902. 

')   Centralbl.  f.  Physiologic,  X,  No.  9,  p.  249. 

')   Annal.  di  Ottalm.,  XXVI,  p.  344- 


TREA  TMEX  T  If  7  TH  X-RJ  YS  311 

no  sensibility  for  the  rays  on  the  part  of  the  retina.  These 
observers  found  that  no  change  takes  place  in  the  appearance 
of  the  visual  purple  on  exposure  to  the  rays;  the  latter,  more- 
over, have  no  effect  upon  the  pigment-epithelium.  On  the  other 
hand,  changes  do  occur  in  the  anterior  parts  of  the  eyeball; 
these,  however,  are  quite  analogous  to  the  changes  in  irradiated 
skin.  The  author  called  attention  some  time  ago  to  the  mild 
attacks  of  conjunctivitis  which  are  liable  to  occur  in  patients 
whose  eyes  are  not  suitably  protected.  Himmel^)  mentions 
the  case  of  a  patient  who  developed  symptoms  of  photophobia 
after  Roentgen-treatment  for  a  patch  of  lupus  on  the  forehead; 
this  Himmel  refers  to  irritation  of  the  optic  nerve.  The  author 
has  pointed  out  in  a  previous  communication  ')  that  troubles  of 
this  kind  can  generally  be  avoided  merely  by  the  patient  closing 
his  eyes  during  the  sitting.  It  would  seem,  therefore  that  the 
Roentgen-rays  themselves  cannot  be  held  altogether  responsible 
for  the  conjunctivitis,  etc.,  since  they  freely  penetrate  the  thin 
tissue  of  the  eyelids.  (3n  the  other  hand,  were  high-tension 
electricity  the  cause  of  the  trouble,  It  can  readily  be  understood 
that  by  closing  the  eyelids  this  electricity  would  be  conveyed  to 
other  parts  of  the  body  and  so  easily  earthed.  Again,  the 
author  has  frequently  seen  conjunctivitis  make  its  appearance, 
although  the  eyes  have  been  covered  by  leaden  masks.  Oiidhi 
looks  upon  accidents  of  this  kind  as  effects  of  the  X-rays  upon 
the  general  organism  ("accidents  generaux"). 

Clialupecky's  experiments^)  shewed  that  inflammation  of 
the  conjunctiva,  when  the  rays  are  directed  straight  upon  the 
eyeball,  may  involve,  by  extension,  the  anterior  chamber  and 
its  vicinity.  This  observer  irradiated  a  rabbit's  eye  for  24  hours 
and  found  the  following  progressive  changes:  Inflammation  of 
the  eyelids,  falling  of  the  eyelashes,  conjunctivitis,  and  irregu- 
larities in  the  cornea;  the  latter  became  greyish-white,  and,  like 
the  conjunctiva,  covered  with  false  membrane.  R.  U.  ff'ild*) 
saw  a  case  in  which  panophthalmitis  supervened  upon  excessive 


•)  L.  c. 

^)  Wiener  mod.  Pressc,  1^99.  No.  .31. 

')  Ccntralhl.  f.  prakt.  Aiigeiilicilk.,  Aiip..  Sept..  p.  267. 

*)  British  Med.   Assoc,   ManclK"^tcr,  July  .30,    1902. 


312  RADIO-THERAPY 

exposure  to  X-rays,  necessitating  enucleation.  Chahipecky 
believes  that  these  effects  upon  the  eyeball  are  common  both 
to  X-rays  and  ultra-violet  rays.  As  a  matter  of  fact,  we  find  in 
the  literature  of  this  subject  morbid  processes  quite  similar  to 
the  above  which  are  ascribed  to  the  action  of  intense  white  light. 
The  effect  of  Roentgen-radiation  upon  living  skin,  and  the 
clinical  and  histological  changes  produced  therein,  will  be  more 
fully  dealt  with  later;  we  have  already  discussed  some  of  these 
changes  when  describing  the  method  of  treatment.  Here  we 
will  only  refer  in  a  general  way  to  the  physiological  peculiari- 
ties which  characterise  the  Roentgen-reaction.  These,  which 
must  always  be  borne  in  mind  during  the  practice  of  Roentgen- 
therapy,  are : 

1.  The  cumulative  effect  of  irradiation.  Although  the 
immediate  effect  of  each  exposure  may  be  but  insignificant,  the 
sum  of  these  effects  goes  on  accumulating,  so  that  in  the  end 
we  may  get  a  sudden  and  unexpected  reaction.  The  more 
intense  the  exposures,  the  sooner  do  the  naked-eye  changes 
become  evident.  The  intensity  and  time  of  appearance  of  the 
reaction,  therefore,  afford  a  criterion  as  to  the  character  of  the 
irradiation  (see  Introduction,  p.  5)  ;  they  also  give  some  indica- 
tion of  the  course  the  reaction  itself  will  probably  run. 

The  author  believes  he  was  the  first  to  point  out 
the  cumulative  action  of  X-rays  (Wiener  med. 
Wochenschr.,  1897,  No.  10),  though  most  writers  give 
Forster  the  credit.  Rie^nhock  and  Scholtz  first  indicated 
the  important  part  played  by  the  intensity  of  the  irra- 
diation in  determining  the  time  of  appearance  of  the 
reaction. 

2.  The  peculiar  character  and  course  of  the  changes  brought 
about  by  irradiation  (reaction,  dermatitis) . 

3.  The  changes  first  affect  the  cells  of  the  skin;  from  this 
the  peculiar  effect  on  the  hairs  arises. 

4.  A  skin  treated  by  Roentgen-radiation  is  for  a  long  time 
afterwards  prone  to  again  react  after  comparatively  weak 
exposures. 

Reports  upon  the  influence  of  Roentgen-rays  on  bacteria  are 
somewhat  conflicting.  Whereas  many  observers  deny  the  rays 


TREATMENT  UlTH  X-RAYS  313 

any  bactericidal  action  whatever  {Beck  and  Schiillz,^)  Beaure- 
gard and  Giiichard/)  Berton,'^)  S.  B  run  ton  Blaikie*)  Blaise 
and  Sauibiic/')  Griinmach,^)  Minck,')  Pott,^)  Sabrazes  and 
Riviere;)  Sormani;")  JFittlin;')  M.  JVolff'')  and  others), 
others  again  found  them  to  possess  distinct  bactericidal 
properties  (Bonomo  and  Gros^^)  Fiorentini  and  Liiraschi,^*) 
Frantzius;^)  Lortet  and  Genoud^'^)  Miihsam;'')  Rieder^^) 
HolzknecJit  and  Spieler  ^")  ) . 

We  can  only  quote  a  few  of  the  experiments  dealing 
with  the  question  of  the  influence  of  Roentgen-irradia- 
tion upon  bacteria. 

F.  Berlioz  (Compt.  rend.  Acad.  d.  Sc,  1896, 
Vol.  II,  p.  109)  irradiated  bouillon-cultures  of  diph- 
theria bacilli  for  16,  32,  and  64  hours.  Guinea-pigs 
were  innoculated  afterwards  with  these  cultures,  and  it 
was  found  that  the  bacilli  had  not  in  the  least  lost  in 
virulence.  This  result  agrees  with  fVade's  (Brit.  Med. 
Journal,  February,  1896)  and  Minck' s  experience. 

Pott"'^)  inoculated  25  test-tubes  containing  glycerin- 
agar-pepton  with  tubercle  bacilli.  The  tubes  were  kept 
for  I  month  at  a  temperature  of  37°  C.     By  this  time 


Zcitschr.  f.  Hyg.,  1896,  p.  490. 

Soc.    de   biolog.,    July   27,    1897. 

La  sem.  nied.,  1896,  p.  283. 

The  Lancet,  1898,  11,  p.  1425. 

Soc.  de  biolog.,  July  10,   1897. 

Quoted  by  Bcrginann. 

Miinchener  med.  Woch.,  1896,  No.  5 ;  1S98,  No.  9. 

The  Lancet,  Nov.  20,   1897. 

Acad,  de  Science,  May  3,  1897. 

Quoted  by  Mollcr. 

Centralbl.  f.  Bakt.,  2.  p.  676. 

Berlin  med.  Gesellsch.,  March  2,  1898. 

Giorn.  med.,  June,  1897. 

Revue  internat.  d'electrotherapie,  Feb.,   March,    1897,  p.   223. 

Centralbl.  f.  Bakt.,  March  5,  1897. 

Compt.  rend.,  March  30,  1896. 

Chirurgenverein,  Berlin,  Jan.   10,  1898. 

Miinchener  med.  Woch.,  1898.  No.  4,  25. 

Wiener  med.  Club,  Jan.  30,  1901. 

The  Lancer,  Nov.  20,  1897. 


314  RADIO-THERAPY 

characteristic  and  pure  colonies  had  developed.  Of 
these  25  tubes  8  were  retained  for  control  purposes  and 
17  were  exposed  to  the  rays.  (It  had  already  been 
determined  that  the  glass-tubes  themselves  offered  but 
slight  resistance  to  the  passage  of  X-rays. )  Means  were 
taken  to  secure  an  equal  exposure  for  all  the  tubes  by 
placing  them  on  a  revolving  stand,  above  which  the 
Crookes  tube  was  fixed.  Photographs  were  taken  from 
time  to  time  to  make  quite  sure  that  the  Roentgen  tube 
was  emitting  X-rays.  The  17  tubes  were  exposed  dally 
for  3  months,  and  in  such  a  way  that  always  the  same 
2  tubes  were  placed  out  of  reach  of  the  rays  after 
I,  I,  2,  4,  6,  8,  and  10  hours  respectively,  while  the 
last  three  tubes  were  exposed  for  1 1  hours  each  day. 
At  the  end  of  the  experiment  It  was  found  that  the 
cultures  had  been  entirely  unaffected  by  this  treatment; 
they  differed  In  no  way  from  each  other,  or  from  the 
cultures  In  the  8  control-tubes. 
This  experiment  conclusively  proves  that  Roentgen-rays 
possess  no  influence  upon  tubercle  bacilli,  and  that  a  Roentgen- 
cure  of  tuberculosis  (If,  indeed,  such  has  been  actually  effected) 
must  be  due  to  other  causes. 

/.  Sahrazes  and  P.  Riviere^)  exposed  cultures  of 
the  bacillus  prodlgiosus  In  a  case  covered  over  with  black 
paper  for  20  days,  giving  dally  irradiations  of  i  hour. 
Absolutely  no  effect  was  produced  on  the  organisms.  In 
a  second  experiment  a  small  opening  was  made  In  the 
abdominal  wall  of  a  frog  by  means  of  a  cautery.  Into 
this  aperture  a  capillary  tube,  which  had  been  previ- 
ously drawn  through  a  culture  of  bacilli,  was  inserted. 
After  an  irradiation  lasting  several  hours,  the  tube  was 
withdrawn  and  Its  contents  examined.  The  results  were 
entirely  negative;  no  Increase  in  the  number  of  white 
blood-corpuscles  or  change  in  the  process  of  phagocy- 
tosis, as  compared  with  non-exposed  control  animals, 
was  discoverable. 


')   Compt.  rend',  de  I'Acad.  de  Sc,  Vol.  CXXIV,  p.  979. 


TREATMENT  iriTH  X-RAYS  315 

H.  Rieder^)  exposed  cultures  of  the  micro-organ- 
isms of  cholera,  anthrax,  typhus,  diphtheria,  also  pus- 
cocci  and  bacteria  coli.  The  cultures  were  covered  by 
leaden  plates,  in  the  centre  of  which  a  large  square 
aperture  had  been  made.  He  found  that  after  48  min- 
utes the  colonies  coinciding  with  the  aperture  perished, 
whereas  the  covered  colonies  continued  to  thrive.  In 
these  experiments  Riedcr  used  a  30  cm.  coil,  the  primary 
current  being  interrupted  300  times  per  minute;  dis- 
tance of  anti-cathode  from  the  object,  10  cm.,  time  of 
exposure,  1-3  hours.  In  some  cases  the  aperture  in  the 
leaden  plate  was  covered  with  black  paper.  In  order 
to  ensure  a  sufficiently  prolonged  action  of  the  most 
intense  rays,  a  second  interrupter  in  the  form  of  a 
metronome  was  introduced  into  the  circuit;  this  was  self- 
acting  and  adjustable.  It  seemed  unlikely  that  the  bac- 
tericidal effect  was  due  in  any  way  to  a  chemical  change 
in  the  nutritive  medium  brought  about  by  heat-rays  or 
fluorescent  light  from  the  vacuum-tube;  there  still 
remained,  however,  the  possibility  of  effects  caused  by 
the  electrical  discharges  from  the  tube.  In  order  to 
eliminate  this  possible  factor,  Riedcr  employed  a  tin- foil 
screen  to  carry  away  the  electricity.  It  was  found  that 
this  procedure  scarcely  affected  the  bactericidal  process. 
Moreover,  on  suitable  arrangements  being  made  to 
eliminate  the  X-rays  themselves  no  bactericidal  action 
could  be  secured.  Finally,  any  action  on  the  part  of 
ozone  was  proved  impossible. 

Rieder  also  claims  to  have  proved  by  experiment 
that  the  production  of  Roentgen-dermatitis  also  is  solely 
due  to  X-rays  themselves  -) .  By  still  more  recent  experi- 
ments, Riedcr'^)  claims  to  have  confirmed  his  earlier 
deductions. 

/..    Lortct   and    Gcnoud^)    also    enquired    into    the 


')  Miinchcncr  mod.  Woch.,  1898.  No.  4.  pp.  101-104. 

'')  Miinchcner  mcd.  Wocli.,  June  21,  i8g8. 

')  Ibid.  March  11,  1902. 

*)  Compt.  rend,  de  I'Acad.  de  Sc,  l8g6,  Vol.  I,  p.   1511. 


3i6  RADIO-THERAPY 

influence  of  Roentgen-radiation  upon  micro-organisms. 
They  were  of  the  opinion  that  even  thin-walled  glass 
test-tubes  offer  considerable  resistance  to  the  passage  of 
X-rays;  consequently  they  irradiated  animals  inoculated 
with  micro-organisms  (tubercle  bacilli) .  These  animals 
were  exposed  daily  to  the  tube  for  at  least  one  hour 
April  25th  to  June  i8th).  Three  animals  which  had 
been  treated  in  this  way  shewed  no  signs  of  tuberculosis, 
whereas  other  animals  employed  for  control  purposes 
(inoculated,  but  not  irradiated)  shewed  abscesses  and 
rapid  emaciation.  As  the  result  of  these  experiments, 
followed  by  microscopic  investigation,  Lortet  and 
Genoiid  concluded  that  Roentgen-radiation  had  modi- 
fied the  effects  of  inoculation.  Fiorentini  and 
Luraschi^)  confirmed  this  opinion. 

R.  Miihsam  ")  inoculated  guinea-pigs  with  tubercu- 
losis and  irradiated  12  of  them  for  one  hour  daily, 
another  12  being  kept  for  control  purposes.  Results 
shewed  that  general  tuberculosis  was  not  prevented  by 
irradiation;  there  was  merely  some  weakening  effect  on 
local  tuberculosis. 

Scholtz^)  exposed  well-developed  plate  cultures  of 
typhus,  cholera,  pyocyaneus  and  trichophyton  germs  to 
soft  tubes  for  i  to  4  hours  with  entirely  negative  results. 
He  believes  that  X-rays  have  no  serious  bactericidal 
effect.  He  was  unable  to  obtain  positive  results  more- 
over in  the  case  of  animals  inoculated  with  tuberculosis. 

The  author  made  the  following  experiments  bear- 
ing upon  this  question :  A  GiindelacJi's  vacuum-tube  was 
employed,  having  a  leaden  screen  fixed  on  it  at  the 
junction  of  the  tube-neck  with  the  globe.  By  this 
arrangement  (Fig.  84)  X-rays  were  excluded  from  the 
region  of  the  tube-neck. 

Two  plate  cultures  of  staphylococcus  pyogenes 
aureus  on  agar  were  placed,  one  at  a  distance  of  i  cm. 


')  L.  c. 

^)   Deutsche  med.  Woch.,  1898,  No.  45. 

')  L.  c. 


TREATMENT  UlTH  X-RJYS  317 

below  the  globe  A'  (./),  and  one  (/?)  at  a  distance  of 
4  cm.  below  the  narrow  end  (//)  of  the  Roentgen-tube. 
Below  J  a  photographic  plate  Pi  was  placed,  wrapped 
in  black  paper,  and  with  its  film  uppermost.  Between 
//  and  Pi  a  leaden  letter  J^  was  placed.  A  leaden  letter 
Bi  was  also  placed  between  B  and  a  second  photographic 
plate  Po.  Plate  J^  was  covered  in  addition  by  a  thick 
aluminium  screen  /Jl,  which  was  connected  with  the 
earth.  After  5  minutes'  working  of  the  tube  the  photo- 
graphic plates  were  de\eloped.  On  plate  Pi  was  to  be 
seen  a  well-marked  white  image  of  the  lettej  J,i ;  the 
other  plate  P.  shewed  a  \'ery  faint  image  of  the  letter 
Bi  and  the  plate  as  a  whole  was  almost  entirely  white. 


iSfch/ 


Fresh  photographic  plates  were  treated  in  precisely 
the  same  way  and  developed  after  5  minutes;  the  results 
were  the  same  as  before.  Fresh  photographs  were  taken 
at  intervals  during  the  half  hour  the  plate  cultures  were 
exposed.  The  negatives  always  proved  that  X-rays  were 
freely  passing  through  the  culture  A  and  the  aluminium 
screen  covering  it,  whereas  through  /?  only  rays  in  small 
amount  were  penetrating.  On  the  other  hand,  /?  was 
throughout  accessible  to  the  silent  discharges  of  high- 
tension  electricity  from  the  tube-surface,  while  A  was 
protected  from  electrical  discharges  by  means  of  the 
aluminium  screen.  The  "earthing"  wires  (^y/^/)  from  the 
latter  ran  to  a  cleft  between  the  ceiling  and  the  wall  of 


3i8  RADIO-THERAPY 

the  room.  7'he  Roentgen-tube  became  very  hot  during 
the  experiment.  After  half  an  hour  both  plates  were 
covered  and  placed  in  the  incubator.  If  now  the  electri- 
cal discharges  and  not  the  X-rays  formed  the«bacteri- 
cidal  factor  in  Roentgen-radiation,  it  was  expected  that 
culture  B  would  appear  destroyed  and  culture  A 
unharmed.  The  reverse,  however,  proved  to  be  the 
case.  A  had  a  sterile  patch  in  the  centre,  whereas  B 
was  uniformly  grown  over  with  colonies. 

This  experiment  seemed  to  indicate  that  the  Roent- 
gen-rays themselves  have  bactericidal  properties. 

On  carefully  considering  the  conditions  of  this 
experiment,  however,  the  author  began  to  doubt  If  A 
had  after  all  been  efficiently  protected  from  electrical 
discharges;  the  earthing  of  the  aluminium  plate  was 
possibly  defective.  Again,  It  seemed  very  likely  that  the 
electric  discharges  striking  B  were  less  powerful  than 
those  proceeding  from  the  curve  of  the  sphere  towards 
A,  so  that  B  might  have  been  Insufficiently  exposed. 

In  order  to  eliminate  these  objections  the  next 
vacuum-tube  experimented  with  was  one  made  by  the 
Voltohmgesellschaft  of  Munich.  This  possessed  two 
spheres  of  almost  equal  size;  the  cathode-rays  were 
produced  In  one  sphere  and  projected  from  the  anti- 
cathode  in  an  opposite  direction  from  the  other  sphere. 
In  this  experiment  earthing  was  secured  by  connection 
with  the  water-pipes.  The  leaden  screen  was  fixed  on 
the  narrow  neck  of  the  tube  between  the  spheres. 

Two  diffused  cultures  of  staphylococcus  pyogenes 
aureus  on  agar  In  Petri-dishes  were  used.  Dish  A  was 
covered  by  a  lid  filled  with  paraffin  wax  and  placed 
beneath  the  sphere  A'j.  Dish  B  was  left  uncovered  and 
placed  beneath  K.,.  Each  dish  was  i  cm.  distant  from 
the  tube ;  the  earthing  In  connection  with  both  dishes  is 
shewn  In  the  diagram  Abl.  Photographic  plates  and 
leaden  letters  were  placed  below  the  dishes  as  in  the 
preceding  experiment,  and  over  A  an  earthed  aluminium 
screen  Al  was  arranged  as  before  (Fig.  85). 


TREATMENT  IVITH  X-RAYS 


319 


The  above  arrangements  precluded  any  possibility 
of  dish  A  being  struck  by  electric  discharges;  on  the 
other  hand  X-rays  were  allowed  to  penetrate  freely, 
as  the  photographs  shewed.  Dish  B  received,  however, 
no  X-rays  at  all,  the  photographic  plate  P.  shewing  no 
darkening  on  development.  This  dish,  however,  received 
practically  the  same  amount  of  electric  discharge  from 
the  sphere  K>  as  was  evolved  from  sphere  A\. 
Exposures  of  one  hour  were  given.  Dish  B  was  then 
covered  and  both  dishes  were  placed  in  the  incubator. 

On  the  following  day  it  was  seen  that  dish  A  shewed 
an  abundant  and  uniform  gro\vth  of  colonies.     Dish  B 


Mi 


Fig.  85. 


Abi 


shewed  a  sterile  patch  in  the  centre  the  size  of  a 
kreutzer.  The  dishes  were  left  in  the  incubator  for 
2  days  more  and  then  photographed. 

The  experiment  was  repeated  five  times;  each  time 
the  same  result  was  obtained,  even  when  longer  expos- 
ures were  given  ^) . 


')  Kicnbock  and  Ilolzknccht  urged  against  this  experiment  that  the  ex- 
posure was  too  brief.  Quite  recent  experiments  by  Grimmach  (1.  c.), 
Scholia  (1.  c),  Zcit  (Boston  Med.  and  Surg.  Journal,  Nov.  1901),  Ascli- 
kinass  and  Caspari  (1.  c.),  however,  quite  confirm  the  author's  experience. 

Even  assuming  that  longer  exposure  with  soft  tubes  would  have  demon- 
strated the  bactericidal  effect  of  X-rays,  it  must  be  borne  in  mind  that  no 
such  exposures  could  be  taken  advantage  of  in  actual  practice,  since  they 
would  inevitably  produce  severe  X-ray  dermatitis. 


320  RADIO-THERAPY 

FVom  these  experiments  it  becomes  evident  that  the  bacteri- 
cidal action  of  X-rays — presuming  such  to  exist — is  very  slight 
compared  with  that  of  the  electrical  discharges  given  off  by  the 
vacuum-tube.  It  may,  indeed,  be  regarded  as  practically  a 
negligible  quantity. 

For  the  purpose  of  studying  the  more  delicate  intracellular 
processes  which  result  from  the  irradiation  of  living  matter, 
causing  visible  changes  and  the  impairment  of  protoplasmic 
function,  one  turns  from  complicated  higher  organisms  to  the 
phenomena  of  plant-life,  to  germinating  seeds  and  plant-cells, 
where  one  can  readily  observe  the  protoplasmic  circulation.  Or 
one  may  employ  the  cells  of  protozoa,  whose  usual  course  of 
existence  is  comparatively  well  understood  (so  that  any  depart- 
ure from  the  normal  can  be  at  once  recognised)  as  the  objects 
of  this  elementary  physiological  enquiry. 

According  to  Maldiney  and  Thouven'm,^)  seeds  of  con- 
volvulus arvensis,  lepidium  sativum,  and  panicium  miliaceum, 
after  one  hour's  exposure  to  Roentgen-rays,  germinate  sooner 
than  others  kept  unexposed  for  control  purposes. 

According  to  Lopriore,^)  Roentgen-rays  have  an  accel- 
erating effect  upon  the  protoplasmic  circulation  in  vallisneria 
spiralis.  If  after  ^  hour's  exposure  the  rays  be  withdrawn  nor- 
mal conditions  again  obtain  amongst  the  cells.  After  i  hour's 
exposure  harmful  effects  can  be  noticed:  the  protoplasm 
assumes  a  yellowish  colour,  becomes  granular  and  vacuolised. 
After  2  hours'  exposure  the  protoplasm  ceases  to  circulate,  and 
the  chlorophyll  bodies  begin  to  lose  their  colour.  Lopriore  also 
examined  the  germination  of  the  pollen  of  genista  and  darling- 
tonia  coronillasfolia  under  the  influence  of  X-rays.  He  found 
the  process  became  suspended.  After  the  experiment  germina- 
tion began  again,  the  pollen  germs  having  absorbed  water  freely 
during  the  exposure. 

F.  Schaiidinn  ")    examined  the   effect  of  irradiation  upon 


*)   Compt.  rend,  de  I'Acad.  de  Sc,  Feb.   14,   1898. 

*)  Azione  dei  raggi  sul  protoplasma  della  cellula  vegetale  vivente  in : 
Nuova  Rassegna.    Catania,  1897. 

')  Ueber  den  Einfluss  der  Roentgenstrahlen  auf  Protozoen  Pfliiger's 
Archiv.    f.  d.  ges.   Physiologie,  p.  29. 


TREATMENT  fJlTII  X-RAYS  321 

separate  animal  cells,  using  cultures  of  protozoa  In  open  glass 
receptacles  for  this  purpose.  One  culture  was  always  reserved 
for  control  purposes,  being  covered  with  a  lead  plate.  The 
vacuum-tube,  covered  with  a  black  cloth,  was  placed  20  cm. 
above  the  cultures,  and  the  exposure  occupied  14  hours. 

Schaudiun  found  that  under  these  conditions  amoebia  prln- 
ceps  Ehrberg  at  first  shewed  signs  of  Increased  activity.  After 
5  or  6  hours  this,  however,  generally  diminished;  after  10  hours 
the  cells  became  clumped  together  In  globules  and  remained 
stationary.  After  the  experiment  many  of  the  cells  died.  The 
rays  had  an  unfavourable  influence  after  4  hours  upon  "amceba 
lucida  Gruber"  and  "pelomyxa  palustris  Greef." 

Trichospha?rIum  sieboldi  Schneider  did  not  react  at  all  to 
the  rays.  On  the  flagellates  (chilomonas  paramicclum  Ehrberg, 
etc.)  irradiation  had  a  harmful  effect. 

Spirostomum  amblguum  Ehrberg  (infusoria)  was  also 
exposed  to  the  rays;  after  4  or  5  hours  activity  was  diminished, 
after  6  hours  the  infusoria  died. 

Schaudiun  argued  from  his  experiments  that  Protozoa 
varied  much  In  their  powers  of  resisting  Roentgen-rays,  Many 
kinds  did  not  appear  to  respond  to  the  Irritation  in  the  least, 
others  reacted  slightly,  and  others  again  very  markedly.  The 
condition  of  the  plasma  seemed  to  bear  a  certain  relationship 
to  the  capacity  for  reaction.  Those  which  reacted  quickly 
possessed  a  loosely-lying  plasma,  and  contained  more  fluid  than 
those  which  were  only  affected  slightly  or  not  at  all. 

Recently  H.  Joseph  and  S.  Prowazek'^)  have  published  a 
series  of  interesting  investigations  on  the  Influence  of  Roentgen- 
radiation  upon  living  protoplasm. 

They  found  in  the  case  of  bryopsis  plumosa  (algae)  that  a 
15  minutes'  exposure  distinctly  slowed  the  protoplasmic  circula- 
tion; also  that  the  plasma  did  not  appear  so  freely  at  the  sites 
of  artificially  produced  lesions.  The  chlorophyll  granules 
became  spindle-shaped  and  arranged  In  rows,  or  sometimes  In 
star-shaped  conglomerations.  Some  time  after  the  irradiation 
conditions  became  normal  again.     These  results  are  somewhat 


*)  Zcitschr,  f.  allg.  Physiologic,  Vol,  I,  Part  II,  1902, 


322  RADIO-THERAPY 

remarkable,  in  view  of  the  fact  that  Lopriore  found  in  the  cells 
of  vallisneria  spiralis  an  acceleration  of  the  protoplasmic  circu- 
lation after  a  half-hour's  exposure. 

When  infusoria  (paramaecium  caudatum  and  volvox)  or 
daphnla?  were  placed  in  a  tube  filled  with  water,  one  half  of 
which  was  covered  with  lead-sheeting,  the  animalculas  collected 
after  10-15  minutes  in  the  portion  where  they  were  protected 
from  the  X-rays.  In  order  to  exclude  the  possibility  of  white 
light  having  some  share  In  this  phenomenon  the  half  of  the 
tube  not  covered  with  lead  was  enveloped  In  a  cloth.  The  result 
was,  however,  the  same. 

Joseph  and  Prowazek  describe  many  other  experiments  upon 
low  forms  of  animal  life.   Hard  or  soft  tubes  gave  like  results. 

All  these  experiments  go  to  show  that  when  administered  to 
a  certain  degree  Roentgen-rays  have  a  stimulating  and  vivifying 
action,  while  beyond  this  limit  they  begin  to  be  injurious.  These 
deductions  agree  entirely  with  clinical  experience.  It  is  known 
that  weak  Irradiations  stimulate  the  granulation  of  atonic  ulcers, 
the  proliferation  of  pigment,  and  the  function  of  hair-papillae. 
The  latter  fact  explains  why  patients  undergoing  Roentgen- 
radiation  for  hypertrichosis  are  left  with  a  stronger  growth  of 
hair  if  for  any  reason  they  are  obliged  to  suspend  treatment  at 
an  early  stage.  These  facts  (including  the  circumstance  that 
Irradiated  tissues  have  for  some  time  afterwards  a  tendency  to 
react  after  comparatively  mild  exposures)  are  similar  to  those 
observed  after  irradiation  by  light.  Axenfeld,  Joseph,  and 
Proivazek' s  observations  have  shown  that  Roentgen-radiation 
stimulates  cell-movement.  We  can,  therefore,  assume  that  the 
effect  of  Roentgen-rays,  like  other  irritants,  is  to  ( i )  stimulate, 
(2)  act  Injuriously,  (3)  promote  activity  (movement). 

§  33.  The  Active  Agent  in  Roentgen-therapy. 

A  vacuum-tube  in  action  emits  various  kinds  of  rays,  and 
gives  rise  to  various  physical  phenomena.  Every  enquiry  under- 
taken for  the  purpose  of  determining  that  precise  factor  to  which 
alone  the  changes  wrought  on  the  living  organism  are  due  must 
first  take  cognisance  of  the  several  effects  produced  on  the  tissues 


TREATMENT  JJ'ITH  X-RAYS  323 

by  the  very  ditterent  physical  agents  which  go  to  make  up  the 
sum  of  these  phenomena. 

On  the  surface  of  and  within  a  vacuum-tube,  in  action,  we 
find: 

1.  Heat; 

2.  Ozone; 

3.  Cathode-rays; 

4.  Ultra-violet  rays; 

5.  Rays  composed  of  material  particles; 

6.  Roentgen-rays; 

7.  Spark-  and  brush-discharges  from  the  high-tension  elec* 
tricity  accumulated  on  the  surface  of  the  tube; 

8.  Electric  or  electro-dynamic  waves; 

9.  Rays  of  unknown  character. 

With  a  knowledge  of  these  facts,  the  author  in  1896  made 
the  experiments  described  on  page  230.  In  these,  by  suitable 
arrangements,  he  absolutely  excluded  the  action  of  other  physi- 
cal agencies  and  was  able  to  ascribe  a  definite  influence  to  the 
Roentgen-rays  themselves.  He  stated  in  effect  that  it  is  to  the 
Roentgen-rays  alone  that  we  must  look  for  the  cause  of  the 
changes  in  the  skin  ^)  The  possibility  of  heat,  ozone,  or  ultra- 
\iolet  rays  having  anything  whatever  to  do  with  his  results  was 
precluded  by  the  condition  of  his  experiments. 

The  assumption  that  other  factors  are  accountable  for  the 
tissue-changes  is,  moreover,  disapproved  by  other  circum- 
stances. 

Teslas  ozone  theory-)  could  not  explain  the  deep-lying 
tissue-changes  which  Gilchrist  )  and  Kaposi'*)  had  observed 
taking  place  in  the  nerves,  ner\'e-shcaths,  periosteum  and  bones 
of  the  extremities,  and  which  //'.  Rcid')  had  seen  in  the  back 
of  a  patient  whose  chest  had  alone  been  exposed  to  the  rays  '"'). 
Still  less  comprehensible  by  this  theory  is  that   fundamental 


')  Wiener  mcd.  Woch.,   1897,  No.   10. 

'^)  Public  Opinion.  Vol.  XXI,  No.  24,  quolcd  by  CJilclnist. 

')  Johns   Hopkins   Hosp.   Bulletin.   February,    1897. 

*)  K.  k.  Ges.  d.  Aerzte  in  Wicn.  Oct.  2J,  1899. 

')  Brit.  Med.  Journal,   1896.  Vol.  II. 

•)  Quoted  by  Mullcr. 


3  24  RADIO-THERAPY 

peculiarity  of  Roentgen-radiation — its  cumulative  action.  It  is 
a  widely  known  fact  that  the  changes  in  the  skin  after  Roentgen- 
radiation  do  not  immediately  follow  on  the  exposure,  but  appear 
many  days  later.  Even  then  they  are  announced  by  alteration 
in  the  deeper  structures  of  the  skin  (shewn  by  falling  of  the 
hair,  pigment  changes,  subjective  symptoms,  etc.),  while  the 
surface  of  the  skin  itself  often  remains  throughout  unaltered  in 
appearance  and  function. 

Bozdes,^)  Stenbeck,-)  and  Elliot  "')  ascribed  the  changes  in 
the  skin  to  the  action  of  ultra-violet  rays  coming  from  the 
Roentgen-tube.  There  can  be  no  question  that  ultra-violet  rays 
are  contained  to  some  extent  in  the  phosphorescent  light  excited 
by  the  cathode-rays  on  the  tube-wall.  But  we  must  not  forget 
that  those  ultra-violet  rays  ha\e  their  origin  zvitli'm  the  tube; 
in  order  to  be  effective  they  must,  therefore,  first  penetrate  the 
glass  wall  of  that  tube.  Now  ordinary  glass  absorbs  these  rays 
to  a  great  extent;  only  certain  kinds  (crown-glass  and  light 
phosphate-crown-glass)   permit  their  passage  to  any  degree^). 

It  is,  therefore,  very  questionable  if  many  ultra-violet  rays 
reach  the  outside  of  the  tube  at  all.  Even  were  this  the  case, 
the  author's  investigations  (p.  231)  and  the  observations  of 
M.  M oiler  ^')  would  seem  to  exclude  the  possibility  of  their 
exerting  any  real  action  in  Roentgen-radiation. 

Aloller  observed  that  a  woman  who  was  being  treated  by 
X-rays  for  lupus  of  the  face  shewed  signs  of  reaction  also 
(pigmentation,  etc.)  on  the  chest,  which  was  covered  by  a  red 
bodice  and  a  black  dress.  Aloller  believes  that  this  phenome- 
non, which  the  author  also  has  repeatedly  observed,  completely 
disproves  the  assumption  that  ultra-violet  rays  have  anything 
to  do  with  the  reaction,  since  they  would  certainly  have  been 
absorbed  in  this  case  by  the  woman's  clothing  °). 


^)   The  British  Journal  of  Dermatology,  July,  1897. 

-)   Quoted   by   Mullcr. 

")   Journal  of  Cutaneous  and  Gen.-Urin.  Dis.,  Feb.  1897. 

*)  For  the  properties  of  different  kinds  of  glass,  see  Eder  &  Valcnta, 
Denkschr.  d.  math.-natur.  classe  der  K.  akademie  d.  Wiss.,  May  4,   1894. 

'')   Einfluss  des  Lichtes  auf  die  Haut.  Bibliotheca  Medica.  Stuttgart.  1900. 

")  Thomson  (Boston  Med.  &  Surg.  Journal,  Dec.  3,  1896)  describes  an 
experiment  which  also  disproves  the  effect  of  ultra-violet  rays. 


TREATMENT  JFITH  X-RAYS  345 

The  author's  experiments  with  regard  to  the  possible  action 
of  the  phosphorescent  light  gave  negative  results.  The  idea  of 
any  real  effect  proceeding  from  the  heat-rays  of  the  vacuum- 
tube  may  be  dismissed  as  improbable.  The  heat  evolved,  espe- 
cially with  the  slow  rate  of  interruption  of  the  primary  current 
usual  in  Roentgen-therapy,  can  be  readily  proved  to  be  so  insig- 
nificant that  it  can  have  no  real  physiological  effect.  This  idea 
is  further  confirmed  by  the  author's  experiment  with  the  alumin- 
ium screen  (p.  23  i ) . 

These  three  factors,  therefore — ozone,  ultra-violet  rays, 
and  heat-rays — can  obviously  have  nothing  to  do  with  the  physi- 
ological effects  of  Roentgen-radiation.  There  is,  perhaps,  more 
to  be  said  for  the  remaining  factors  above  mentioned,  though 
there  are  many  objections  to  be  urged  against  nearly  all  of 
these. 

Against  the  cathode-ray  theory  of  Gilchrist,^)  Ames,') 
and  Foveau  de  Courmelles,^)  it  may  be  urged  that  though 
cathode-rays  have  the  power  of  penetrating  very  thin  layers  of 
aluminium,  as  Hertz  showed,  their  progress  is  arrested  by  even 
thin  layers  of  other  bodies,  such  as  glass.  Consequently  the 
glass  wall  of  the  vacuum-tube  would  prevent  most,  if  not  all, 
of  these  rays  from  reaching  the  exterior  of  the  tube  *). 

A  very  interesting  theory  has  been  propounded  that  the 
skin-changes  are  due  to  a  direct  bombardment  with  material 
particles  emanating  from  the  electrode.  Crookes '')  believed 
that  when  the  discharges  from  a  Ruhnikorff  coil  are  passed 
through  a  vacuum-tube,  small  particles  are  driven  off  from 
the  cathode.  These  are  either  particles  of  the  gas  within  the 
tube  or  are  particles  of  the  cathode-  itself;  they  may,  again,  be 
electrolytic  elements  of  the  gas-molecule.  Tt  is  a  matter  of 
common  knowledge  that  the  region  of  a  tube  opposite  the 
cathode  becomes  blackened  after  prolonged  use.  This  blacken- 
ing is  due  to  a  deposit  of  material  particles  driven  off  the  elec- 


')  L.  c. 

')  Quoted  by  Gilchrist. 

')  Congr.  f.  Neurolog.,  Brussels,  1S97. 

*)  Gractc,  Die  Elektricital.  StuUgarl,   1898,  p.  272. 

')  Quoted  by  Gractz. 


326  RADIO-THERAPY 

trode.  But  against  this  theory  of  material  particles  It  must  be 
urged,  ( I )  that  it  has  not  yet  been  proved  that  the  particles 
penetrate  the  tube-wall  and  so  arrive  at  the  skin;  (2)  that  no 
evidence  has  been  as  yet  forthcoming  of  the  presence  of  this 
foreign  matter  In  the  skin,  Gilchrist  examined  a  specimen  of 
skin  after  exposure  to  X-rays,  the  pigmentation  in  which  was 
so  pronounced  that  the  idea  was  suggested  of  there  being  possi- 
bly an  Invasion  of  aluminium  particles  In  the  tissue.  Neverthe- 
less under  the  microscope  no  trace  of  metallic  or  other  foreign 
bodies  could  be  discovered.  Abel  made  chemical  Investigations 
with  the  same  results.  Tesla,  who  supports  the  theory  of  bom- 
bardment by  material  particles  (1.  c),  gives  the  comforting 
assurance  that  It  would  take  at  least  a  century  before  a  sufficient 
quantity  of  the  foreign  matter  collected  would  seriously 
threaten  the  health  of  the  person  undergoing   Irradiation. 

Any  possible  action  on  the  part  of  the  tension-electricity 
accumulated  on  the  surface  of  the  Roentgen-tube  (such  as  was 
suggested  by  Destot,^)  Balthasard,~)  Jankaii,^)  Foveau  de 
Coiirmelles,'^)  Apostoli,^)  Lester  Lenard,^)  and  the  author  ^), 
seemed  excluded  by  the  above-mentioned  experiment;  the  alum- 
inium screen  undoubtedly  conveyed  all  the  electricity  to  the 
ground;  moreover,  JV.  Reid's^)  observation  seemed  also  to 
negative  the  electrical  theory.  Reid's  observation,  confirmed 
later  by  Kiimmel  and  Revillet,^)  shewed  that  changes  occurred 
not  only  in  the  area  of  skin  directly  exposed  to  the  rays,  but 
also  In  a  corresponding  area  of  skin  on  the  opposite  side  of  the 
body,  where  the  rays  emerge.  This  circumstance  seemed  also 
to  speak  against  any  electric-wave  hypothesis;  moreover,  any 
theory  of  this  kind  could  not  explain  the  negative  results  of  the 
author's  experiment  with  the  reversed  current  (p.  231), 


Quoted  by  M'dller. 

Soc.  de  biologie,  July  17,  1897. 

Photogr.  Monatsh.  f.  Med.,  1896,  No.  6. 

Soc.  de  biologie,  July  17,  1897. 

Internat.  med.  congr.,  Moscow,  1897. 

The  American  X-ray  Journal,  1898,  No.  5. 

Vortr.  in  der  Gesellsch.  d.  Aerzte  in  Wien,  Jan.  15,  1897. 

British  Med.  Journal,  1898,  Vol.  II. 

Quoted  by  M'dller. 


TREATMENT  IVITH  X-RAYS  327 

The  author's  theory  that  the  X-rays  themselves  are  the  active 
factor  of  Roentgen-therapy  was  held  also  by  GocJit,^)  Kiim- 
mel,'-)  Ricder;^)  A Ibers-Schonberg,*)  and  others. 

Against  even  this  view,  however,  came  the  following  obser- 
vation:  The  author  treated  a  woman  for  hypertrichosis;  during 
the  whole  course  of  treatment  very  hard  tubes  only  were 
employed,  so  that  at  no  time  could  the  least  trace  of  fluores- 
cence be  seen  on  the  screen.  Plainly  there  were  practically  no 
X-rays  evolved  from  the  tube.  Nev^ertheless,  after  a  certain 
time,  the  hair  began  to  fall.  Struck  by  this  fact,  the  author 
treated  a  similar  case  with  the  current  reversed  throughout. 
Thus  the  experiment  he  made  in  1896  was  repeated,  with  the 
exception  that  in  this  instance  (no  result  being  evident  by  the 
twelfth  day,  as  was  usual  with  the  ordinary  arrangement  of 
current)  the  exposure  was  prolonged  for  8  or  10  days.  By 
this  time  the  hair  began  to  fall.  A  repetition  of  this  experiment 
with  a  third  patient  yielded  the  same  result.  Obviously,  there- 
fore, the  Roentgen-rays  cannot  be  the  sole  cause  of  the  changes 
in  the  skin. 

This  V'iew  was  confirmed  by  iroyzekozvski's  '')  experiments 
on  rabbits.  In  every  case  where  the  X-rays  alone  were 
employed,  electricity  and  light  being  excluded  as  far  as  possi- 
ble, no  injurious  effects  were  to  be  seen;  when,  however,  the 
X-rays  were  used  in  conjunction  with  the  other  varieties  of 
radiation  emanating  from  the  tube,  physiological  effects  fol- 
lowed in  from  3-12  hours. 

A  further  striking  fact,  which  could  be  noted  at  any  sitting, 
seemed  also  to  point  to  electrical  energy  as  bearing  some  casual 
-elatlonship  to  the  physiological  effects.  When  the  apparatus 
IS  In  action  the  patient  and  the  objects  surrounding  him  become 
so  charged  with  electricity  that  sparks  can  be  drawn  with  the 
knuckles  from  any  part  of  his  body.     The  patient  has  often 


')   Fortschr.  a.  d.  Gel),  d.  Rocntgcnstr.,  Vol.  I,  No.   i. 
')  Quoted  by  Gocht. 

*)   Miinchener  med.  Woch..  1897,  No.  10. 
*)   Ibid.    1900,  Nos.  9,  10,  II. 

")  Quoted  by  Zarnbin,   Monatsh.    f.   prakt.   Derm.,    1899.   Vol.   XXVIII, 
No.  ID. 


328  RADIO-THERAPY 

the  sensation  of  being  in  a  light  current  of  air  ("electric 
wind")  ;  his  hairs  are  attracted  towards  the  tube.  Next  came 
detailed  acounts  from  d'Arsonval  and  Oiidin  of  the  therapeutic 
employment  of  Tesla's  high-frequency  currents^) .  On  comparing 
the  effects  of  these  currents  with  those  of  Roentgen-radiation, 
the  author  was  at  once  struck  by  many  points  of  resemblance 
between  the  two.  Might  not  spark-discharges  from  the  coil  in 
the  case  of  Roentgen-radiation  also  play  an  important  part  in 
the  physiological  action?  Since  the  experiment  with  the  alumin- 
ium screen  argued  against  any  direct  spark-effect,  it  seemed 
natural  to  conclude  that  the  electric  vibrations  due  to  the  spark- 
discharges  were  accountable  for  the  physiological  effects,  and 
that  the  intensity  of  the  latter  varied  with  the  physical  qualities 
of  the  electric  vibrations. 

This  idea,  however,  to  which  the  author  gave  expression  at 
a  meeting  of  the  Wiener  dermatologischen  Gesellschaft,  May 
loth,  1899,^)  appeared  somewhat  at  variance  with  the  fact 
that  not  only  the  leaden  masks  in  common  use,  but  even  masks 
of  cardboard^)  or  ordinary  paper,*)  were  sufficient  for  pro- 
tective purposes.  Since  electric  waves  penetrate  all  bodies,  with 
the  exception  of  metals,  and,  moreover,  since  they  are  trans- 
mitted in  all  directions  from  the  sparking-path  (just  as  waves 
of  light  are  propagated  in  all  directions  from  the  point  of 
origin),  their  effect  would  not  be  confined  to  the  region  directly 
opposite  their  source,  and  still  less  would  their  progress  be 
arrested  by  a  sheet  of  paper.  Further,  doubts  arose  whether 
electric  vibrations  really  emanate  from  a  Roentgen-tube. 
According' to  /.  Tuma^')  most  probably  no  electro-magnetic 
waves  arise  in  this  way. 

In  the  endeavour  to  throw  light  on  this  perplexing  problem. 


^)  Annales  d'electrobiologie,  d'electrotherapie  et  d'electrodiagnostie,  Jan. 
IS,  1898. 

')  Wiener  med.  Presse,  1899,  No.  31,  and  Wiener  klin.  Woch.,  1899, 
No.  39. 

^)   Hahn  and  Albcrs-S chbnbcrg,  Miinchener  med.  Woch.,  March  13,  1900. 

*)  Stenbeck,  quoted  by  M'dllcr. 

*)  Quoted  in  the  author's  work  "Die  physiolog.  Wirkungen  der  Polent- 
ladungen  hoch-ge.spannter  Inductionsstrome."  Sitzungsb.  d.  Akad.  der 
Wiss.   in  Wien,  Math.-naturw.   CI.,  Vol.   CIX,   Section  III,  p.   594, 


TREATMENT  UITH  X-RAYS  329 

the  identity  of  the  active  agent  in  Roentgen-therapy,  the  author 
felt  bound  to  reconsider  the  question  of  the  spark-discharges. 
Two  considerations  in  particular  influenced  him  in  this  direction. 
The  first  was  the  question  as  to  whether  in  his  first  experiment 
the  aluminium  screen  had  actually  "earthed"  all  the  discharges; 
it  seemed  at  least  within  the  bounds  of  possibility  that  more  vig- 
orous sparks  should  have  penetrated  the  screen.  He  remem- 
bered, moreover,  that  from  the  kind  of  tube  he  was  at  that 
time  employing  (a  small  vacuum-tube  from  Stiitzerbach) ,  often 
powerful  sparks  struck  the  screen,  and  that  on  the  correspond- 
ing area  of  skin  the  necrosis  made  its  appearance  later.  Again, 
it  seemed  not  impossible  that  the  vacuolisation  degeneration 
discovered  by  Gassmann  in  the  cells  of  the  intima  of  the  vessel- 
walls,  in  cases  of  Roentgen-ulceration,  might  be  traced  to  the 
effects  of  direct  spark-discharges. 

It  seemed  essential,  therefore,  to  study  the  physiological 
effects  of  spark-discharges  pure  and  simple — hence  the  experi- 
ments described  on  page  121  and  onwards.  Thus  the  fact  was 
established  that  direct  spark-discharges  from  a  Riihmkorff's 
apparatus  have  a  similar  influence  on  the  skin  and  on  bacteria 
to  that  which  has  been  ascribed  to  Roentgen-radiation.  This 
led  one  to  the  conclusion  that  electric  discharges  constitute  the 
essential  factor  in  Roentgen-therapy. 

Recently,  however,  Striiltcr,^)  Kienbock,')  and  Scholtz^) 
have  described  a  series  of  experiments  tending  to  show  that 
X-rays  themseK^cs  possess  a  physiological  action.  These  investi- 
gators shew  that  irradiation  by  means  of  soft  tubes,  which 
evolve  X-rays  copiously,  brings  about  reaction  in  the  same 
individuals  much  earlier  than  irradiation  with  hard  tubes,  which 
give  a  comparatively  small  output  of  X-rays. 

Kienbock  urged  the  fact  that  the  skin  reaction  only  appears 
on  the  area  exposed  to  the  X-rays,  and  that  by  fixing  a  leaden 
screen  between  the  tube  and  the  surface  of  the  skin  a  white 
patch   (corresponding  to  the  screen)'  is  produced,  surrounded 


')   Deutsche  mcd.  Wochensclir.,  August,  igoo,  p.  546. 
^)   Wiener  klin.  Wochenschr.,   1900,   No.  50. 
')  L.  c. 


330  RADIO-THERAPY 

by  a  zone  of  erythema.  The  eiiect  on  the  skin  Is  weakened 
according  as  other  bodies  are  Interposed  between  the  tube  and 
the  body.  The  same  Investigator  arranged  a  tube  In  such  a 
way  that  the  mirror  of  the  anti-cathode  lay  at  right  angles  to 
the  surface  of  the  skin.  Thereby  only  that  portion  of  skin 
underlying  the  fluorescent  half  of  the  tube  was  subjected  to 
X-rays;  behind  the  mirror  the  tube  was  dark,  and  from  here 
but  few  X-rays  struck  the  skin.  Reaction  only  appeared  in  the 
first-mentioned  area  of  skin;  the  border  of  this  reactive  zone 
coincided  with  the  plane  of  the  anti-cathode  mirror. 

There  are  several  objections  to  be  raised  against 
these  experiments.  In  the  first  place,  it  Is  well  known 
that  under  certain  conditions  even  hard  tubes  bring  about 
reaction  far  earlier  than  was  anticipated.  Again,  it  Is 
quite  clear  that  leaden  plates  not  only  Intercept  X-rays, 
but  also  spark-discharges.  Finally,  it  must  be  men- 
tioned that  the  high-tension  electricity  is  not  evenly  dis- 
tributed over  the  surface  of  the  tube,  as  we  are  given 
to  suppose,  but  has  certain  peculiarities  In  this  respect. 
E.  Riccke'^)  examined  the  distribution  of  free  elec- 
tricity on  the  surface  of  a  Crookes  tube,  actuated  by  an 
induction-apparatus,  by  dusting  the  tube  with  a  mixture 
of  red  lead  and  powdered  sulphur.  Peculiarly  shaped 
figures  appeared  on  the  tube-surface;  a  ring  was  seen 
opposite  the  cathode,  sharply  outlined  by  yellow  pow- 
der. The  ring  was  situated  somewhere  about  the  bor- 
der of  the  brightly  fluorescing  part  of  the  tube-wall. 
Within  the  ring  alone  red  spots  were  seen;  these  were 
composed  of  positively-electrified  red-lead  powder.  The 
distribution  of  the  red  powder  was  uneven,  probably 
on  account  of  the  uneven  condition  of  the  cathode- 
surface. 

Metal  wires  and  plates  placed  within  the  tube  in 
the  path  of  the  cathode-rays  caused  shadows  to  appear 
on  the  tube-wall;  these  shadows  were  also  indicated  by 
the   disposition   of   the   powder.      The   shadows   were 


')   Wiedcm.  Ann.,  Vol.  LXIX,  1899,  p.  788. 


TREATMENT  WITH  X-RAYS  331 

sharply  outlined  by  streaks  of  red  powder;  the  shadows 
themselves  were  either  free  from  powder  or  covered 
in  the  middle  with  powdered  sulphur. 

The  author's  own  experiments  confirmed  those  of 
Riecke.   He  observed  a  striking  arrangement  of  the  yel- 
low powder  in  the  form  of  broad  rings  opposite  the 
poles  of  the  tube.    Moreover,  in  the  brightly  fluorescing 
portion   of  the   tube   placed  opposite   to   the   skin   the 
accumulation  of  free  electricity  was  especially  marked. 
The  following  experiment  seems  convincing: 
Scholtz  ^ )    irradiated  a  circular  patch  of  skin,  the  size  of 
one's  palm,  on  a  hog's  back.     The  exposure  was  continued  for 
^   hour,   and  the  patch  was  divided  into   5    segments;  4  of 
these  segments  were  covered  with  lead,  glass,  aluminium  and 
paper  respectively,  while  the  fifth  was  left  uncovered.     After 
30  days  the  hairs  loosened  in  the  uncovered  and  paper-covered 
segments;  later  on,  when  the  same  phenomenon  began  to  shew^ 
itself  also  in  the  aluminium-covered  segment,  the  first-mentioned 
segments  shewed  a  superficial  necrosis.     In  the  glass-  and  lead- 
covered  regions  absolutely  no  changes  were  visible.     In  a  later 
experiment,  Scholtz  shewed  that  mercurial  plaster  also  forms 
an  effective  screen  against  irradiation. 

In  order  to  demonstrate  that  the  alteration  in  the  tube- 
vacuum,  which  occurs  during  every  irradiation,  has  an  impor- 
tant bearing  on  the  physiological  effect,  Scholtz  -)  exposed  the 
left  flank  of  a  rabbit  to  a  small  "hard"  tube,  which  became 
"soft"  after  5  or  6  minutes'  use;  after  that  the  tube  was  brought 
to  bear  on  the  right  flank.  After  four  irradiations  in  this  man- 
ner an  alopecia  appeared  on  the  right  side,  while  on  the  left 
there  was  only  a  slight  fall  of  hair. 

In  order  to  decide  whether  Roentgen-rays  are  effective  after 
they  have  actually  penetrated  the  tissues,  Scholtz  exposed  cer- 
tain regions  on  the  backs  and  throats  of  rabbits  and  pigs  over 
which  he  had  fastened  the  animals'  cars.  The  irradiation  was 
vigorous,  and  inflammatory  reactions  were  induced  not  only  on 


0   Arch.  f.  Derm,  iiiul  Sypli.,  Vol.  LIX,  Tart  T. 
^)  L.  c. 


332  RADIO-THERAPY 

both  sides  of  the  ears,  but  also  on  the  parts  beneath  the  ears. 
According  to  Scholtz,  the  muscles,  cartilages,  and  bones  are  not 
affected;  necrosis  in  these  structures  is  generally  secondary  only 
to  inflammation  of  the  skin. 

Scholtz  believes  that  Roentgen-rays  exert  their  effects  in  the 
first  instance  upon  the  skin.  These  skin-effects,  moreover,  do 
not  only  occur  where  the  rays  enter  the  body,  but  may,  after 
the  penetration  of  thin  layers  of  muscle  and  cartilage,  occur  at 
the  site  of  exit.  At  the  same  time  comparatively  thin  layers  of 
tissue,  which  only  show  faint  grey  shadows  on  the  fluorescent 
screen,  considerably  weaken  the  effect  of  the  rays. 

Schollz  summarises  as  follows : 

1.  The  greater  the  output  of  X-rays  from  the  tube,  the 
greater  the  effect  on  the  skin. 

On  this  ground,  according  to  Scholtz,  the  therapeutic  use 
of  soft  tubes  is  advisable.  He  recommends  varying  the  intensity 
of  treatment  by  alterations  in  the  strength  of  current,  the  tube- 
distance,  and  the  duration  of  exposure. 

2.  The  less  a  given  substance  allows  Roentgen-rays  to  trav- 
erse it,  the  more  does  it  restrain  effective  rays  from  reaching  the 
skin. 

Bodies,  such  as  an  aluminium  screen,  which  throw  only 
feeble  shadows  on  the  fluorescent  screen,  hold  back,  neverthe- 
less, a  relatively  large  part  of  the  effective  rays.  In  other  words, 
it  Is  just  the  weakly-penetrating  rays  which  are  especially  active 
on  the  skin. 

From  the  foregoing  experiments  it  becomes  evident  that  of 
all  the  physical  factors  emanating  from  an  X-ray  tube  only  the 
Roentgen-rays  themselves  and  the  discharges  of  high-tension 
electricity  from  the  tube-surface  can  he  considered  responsible 
for  the  physiological  effects.  Both  these  agents  appear  simul- 
taneously while  the  tube  is  working,  both  have  demonstrably 
similar  effects,  and  these  effects  supplement  and  accentuate  each 
other. 

The  latter  hypothesis  appears  borne  out  by  the  following 
experiment : 

A  severe  case  of  hypertrichosis  of  both  cheeks  and 
the  chin  was  treated  by  the  author  as  follows :  The  right 


TREATMEM  IT  1111  X-R.WS 


333 


cheek  was  exposed  for  the  first  20  minutes  to  the  "quiet" 
discharges  from  the  special  electrode,  which  has  heen 
described  earlier.  After^^a^ds  the  same  cheek  was 
treated  with  Roentgen-ravs  for  1 5  minutes,  the  tube- 
distance  being  15  cm.  1  he  tube  was  a  very  soft  one,  ami 
could  be  touched  without  one  receixing  any  perceptible 
electric  ciischarge.  The  left  cheek  was  simply  exposed 
to  the  same  Roentgen-tube  for  i  ^  minutes  at  the  same 
tube-distance.       It    would    be    approximately    correct. 


Fig.  86. 

therefore,  to  say  that  the  right  cheek  received  X-rays 
plus  electric  discharges,  the  left  check  X-rays  alone. 
The  experiment  was  continued  daily  in  this  manner, 
and  after  the  sixth  day  the  right  cheek  shewed  distinct 
signs  of  reaction,  the  hairs  fell,  well-marked  erythema, 
etc.,  followeil.  The  Kit  cheek  shewed  as  yet  no  signs 
of  change;  this  region  was,  therefore,  exposetl  S  times 
further.  After  this,  slight  erythema  and  pigmentation 
shewed  themselves,  and  a  week  later  the  hairs  began  to 


334  RADIO-THERAPY 

fall.     The  reaction,  however,  on  this  side  throughout 
ran  a  milder  course  than  on  the  right.     The  experiment 
was  repeated  many  times  with  the  same  result.     Reac- 
tion and  epilation  always  followed  in  a  few  days  after 
treatment  with  high-tension  electricity  and  X-rays,  and 
the  reaction  was  always  most  evident  in  those  places 
which  had  been  bombarded  most  vigorously  by  the  dis- 
charges  (Fig.  86).     These  regions  appeared  intensely 
red.     The  rest  of  the  skin  shewed  the  usual  slight  pig- 
mentation and  erythema  of  commencing  reaction.     The 
combination   of  both   methods   also   in   cases   of   lupus 
ulcerations  determined  an  earlier  reaction  and  hastened 
the  healing  process. 
As  regards  the  quality  of  tubes,  it  is  certain  that  in  most 
cases  soft  tubes  are  more  powerful  and  act  sooner  than  hard 
tubes.     At  the  same  time  the  rays  emanating  from  hard  tubes 
(including  the  electric  discharges)    appear  to  penetrate  more 
deeply  than  those  from  soft  tubes. 

Holzknecht's  opinion  is  that  any  deeper  action  on 
the  part  of  X-rays  is  impossible,  since  the  physiologically 
active  rays  are  absorbed  by  the  skin,   and  only  those 
rays    which    are    inactive    are    allowed    to    penetrate. 
Against  this  we  need  only  refer  to  the  fact  that  animals 
which  have  been   exposed   for  a   considerable  time  to 
Roentgen-radiation  show  dermatitis  on  both  sides  of  the 
body. 
In  conclusion,  we  may  discuss  the  mechanism  of  the  physio- 
logical process.       The   action  of  electric  discharges  has  been 
already  explained    (p.   159).    With  regard  to  the  X-rays,  the 
assumption  that  we  have  here  to  deal  with  a  pronounced  local 
action   is  opposed  by  the  so-called   tropho-neiirotic  theory  of 
Oudin   and  Barthelemy  ^) .    These   authorities   look  upon   the 
reaction  as  a  reflex  process  arising  from  the  central  nervous 
sysrem  through  stimulation  of  the  cuticular  nerves.    This  theory 
may  be  abandoned  in  view  of  the  local  macro-  and  microscopical 
changes  already  described  as  occurring  in  irradiated  tissues,  bear- 


*)  Monatsh,  f.  prakt.  Dermatologie,  Vol.  XXV,   1897,  p.  417. 


TREATMENT  IFITH  X-RAYS  335 

ing  in  mind,  moreover,  that  there  is  complete  absence  of  any 
symptoms  on  the  part  of  the  brain  and  spinal  cord,  or  of  any 
proof  of  peripheral  nerve  lesions  ^) . 

The  action  of  X-rays  is  doubtless  purely  local,  but  as  to  its 
precise  character  there  is  still  much  to  be  learned.  Kienbock 
believes  in  a  chemical  action,  leading  to  disturbances  of  meta- 
bolism by  which  the  cells  of  the  tissue  are  led  to  react  in  the 
form  of  Roentgen-dermatitis.  The  action,  however,  cannot  be 
purely  chemical,  for  most  enquiries  shew  that  X-rays  have 
remarkably  weak  chemical  properties  -). 

The  action  of  X-rays  on  a  photographic  plate  must  not  be 
taken  as  a  proof  of  the  direct  chemical  effect  of  the  rays  on 
bromide  of  silv^er.  Eder  and  Valcnta  have  shewn  that  X-rays 
act  on  silver  bromide  gelatine,  but  not  on  collodion  plates;  this 
sufficiently  proves  that  the  photographic  action  of  the  rays  is  a 
highly  complicated  process,  which  does  not  consist  merely  in  the 
reduction  of  bromide  of  silver. 

The  author  believes  that  through  the  destruction  of  tissue- 
elements  certain  products  arise  whose  absorption  leads  to  consti- 
tutional symptoms.  This  would  explain  the  appearance  of  fever 
at  the  commencement  of  severe  Roentgen-dermatitis,  before  any 
excoriation  or  ulcer  affords  the  opportunity  for  local  infection. 

Jankau^)  believed  that  electrolytic  analysis  of  the  cells 
takes  place  from  irradiation,  whereby  the  tissues  are  chemi- 
cally affected  and  inflammation  is  provoked. 

Kaposi")  advanced  the  theory  that  Roentgen-rays  affect  the 
vascular  system  in  the  deeper  layers  of  the  skin  similarly  to  sun- 
light, so  that  first  an  active  and  then  a  passive  hypera^mia 
results,  which  slowly  extends  to  the  more  superficial  vessels. 

It  is  well  known  that  during  the  phenomenon  of  osmosis 
a  slight  potential-difference  arises  on  both  sides  of  the  diaphragm 
through  which  the  passage  of  the  liquid  particles  takes  place. 
H.  Bordier'')    affirms  that  under  certain  experimental  condi- 


')  Jutassy,  1.  c. 

^)  A.  V.  Hemptinne,  Zeitschr.  f.  physik.  Chcmic,  Vol.  XXT,  3,  p.  4Q3- 

')  Intcrnat.  photog.  Monatsschr.  f.   Mcdicin,  Vol.  V,  No.   I. 

*)  K.  k.  Ges.  cl.  Aerztc  in  Wicn,  Jan.   15.  i897- 

")  Acad,  dc  Sc.  Conipl.  rend.,  Vol.  CXXVI,  p.  595- 


2,1,6  RADIO-THERAPY 

tions  Roentgen-radiation  retards  the  process  of  osmosis.  An 
aluminium  plate  connected  with  the  earth  and  introduced 
between  the  Roentgen-tube  and  the  osmometer  in  no  way  inter- 
feres with  this  retarding  process.  Consequently  Bordier 
ascribes  the  retarding  influence  to  the  X-rays  themselves.  Bor- 
dier explains  this  effect  by  the  disturbing  influence  of  X-rays  on 
the  electro-capillary  phenomenon  taking  place  in  the  membrane 
during  osmosis.  Since  many  vital  processes  in  the  cell  depend 
upon  the  proper  performance  of  this  function  of  osmosis, 
Bordier  believes  that  in  the  retardation  of  the  latter  is  to  be 
found  the  cause  of  many  biological  and  therapeutic  effects. 

The  author  believes  that  the  pathological  changes  in  irra- 
diated tissue  may  be  explained  by  the  disturbance  of  a  pre- 
existing electrical  equilibrium  in  the  several  tissue  molecules  by 
the  X-rays,  which  possess  the  property  of  discharging  electri- 
cally-laden bodies.   B.  IF  alter  ^)  also  shares  in  this  view. 

It  seems,  moreover,  not  impossible  ')  that  X-rays  induce 
fluorescence  in  those  tissue-elements  capable  of  this  phenome- 
non, and  that  this  process  brings  about  chemical  changes,  espe- 
cially in  the  cells.  In  this  respect  those  tissues  which  contain 
earthy  matter  would  appear  to  possess  some  affinity  to  the 
bromide  of  silver-gelatine,  while  other  tissues,  which  have  no 
fluorescence  capacity,  remain  unharmed  by  the  rays. 

Quite  recently,  Goldstein,  arguing  from  the  supposi- 
tion that  where  Roentgen-rays  impinge  upon  material 
bodies  ultra-violet  light  of  very  short  wave-length  is 
produced,  ascribed  to  this  ultra-violet  light  the  cause  of 
the  biological  effects  produced  in  the  deeper  layers  of 
the  skin  by  Roentgen-radiation^).  According  to  this 
view,  it  is  difficult  to  see  why  the  rays  should  exert  their 
influence  mainly  on  the  skin.  They  penetrate  the  whole 
body,  and  would,   therefore,   cause   the   production   of 


')   Fortschr.  a.  d.  Geb.  d.  Roentgenstrahlen,  Vol.   I,  No.  6,  p.  242. 

')  The  author  communicated  this  view  to  a  meeting  of  the  Vienna 
Medical  Club,  Jan.  30,  1901. 

')  Sitzungsbericht  d.  k.  preuss.Akad.  d.  Wissenschaften.  quoted  by  Hoh- 
linecht,  Die  Photpchem.  Grvindlagen,  etc.  Fortschr.  a.  d.  Geb.  d.  Roentgenstr., 
Vol  V. 


TREJTMEXT  iriTH  X-RJYS  337 

ultra-violet  light  in  the  internal  organs  (the  heart, 
liver,  etc.,  where  they  are  also  absorbed)  and  so  bring 
about  changes  there,  which  certainly  is  not  the  case. 
This  difficulty  does  not  arise  with  the  author's  hypoth- 
esis, for  it  is  well  known  that  the  animal  tissues  do  not 
all  possess  in  the  same  degree  the  capacity  for  fluores- 
cence. 

§  34.  Roentgen-ray  Dermatitis.' 

The  pathological  changes  in  the  skin  which  go  by  the  name  of 
"X-ray  dermatitis"  present  the  following  clinical  appearances: 
At  first  we  have  the  milder  signs  of  reaction  already 
referred  to :  turgescence  of  the  skin,  pigment  changes,  pale- 
red  erythema,  loosening  of  hairs,  and  subjective  phenomena 
(itching,  burning,  feeling  of  tension). 

Where  the  action  is  stronger  the  hairs  begin  to  fall  in  from 
3  to  14  days  after  the  last  exposure;  first  the  thicker,  and  then 
the  lanugo-hairs  (seldom  otherwise).  The  redness  gradually 
becomes  intensified,  more  and  more  cyanotic;  while  a  small  area 
of  the  skin  (where  the  irradiation  has  been  the  strongest)  soon 
shows  superficial  excoriation.  The  latter,  which  is  accompanied 
by  severe  pain  (see  p.  251),  and  often  fever,  rapidly  spreads 
centrifugally. 

Many  authors  affirm  that  Roentgen-dermatitis  runs 
a  painless  course.  The  author  cannot  substantiate  this 
from  the  cases  which  have  come  under  his  notice.  These 
were  accompanied  by  considerable  pain,  especially  when 
the  raw  surfaces  were  exposed  to  the  air.  In  the  case 
of  naevus  pigmentosus  pilaris,  which  was  mentioned 
earlier  in  this  work,  and  which  was  the  occasion  of  the 
first  experiment  in  Roentgen-therapy,  the  pain  was  at 
first  trifling.  Later  on,  however,  when  ulceration 
shewed  itself,  the  pain  became  at  times  very  severe,  espe- 
cially at  night. 
The  author  has  only  seen  pustuhir  and  bullous  formations 


')   The  list  of  Reports  on   X-ray   Dermatitis   is  a  very   large  one.     The 
reader  is  referred  to  Magnus  Mailer's  I)ook. 


338  RADIO-THERAPY 

in  the  above-cited  case,  though  these  are  described  as  constant 
by  several  authors  {Ehrmann,  Kienbock,  and  others).  The 
excoriations  have  a  yellow-red,  smooth,  wax-like  appearance; 
they  secrete  a  quantity  of  thin  pus,  and  are  covered  by  a  peculiar 
(fatty-fibrinous)  coating,  which  is  with  difficulty  removed 
(this  coating  does  not  give  a  fibrin-reaction:  Lion)  ;  at  their 
border  are  seen  circular  or  oblong  islands  of  epithelium  which 
may  have  bridge-like  processes  extending  to  the  healthy  skin  in 
the  neighbourhood.  After  very  powerful  irradiation  a  whitish 
patch  (the  "Roentgen-slough")  differentiates  itself  in  the  middle 
of  the  excoriation.  This  becomes  gradually  darker  and  finally 
separates.  The  more  powerful  the  irradiation,  the  sooner  these 
phenomena  shew  themselves. 

Repair  sets  in  as  follows: 
•The  slighter  signs  of  reaction  which  are  the  result  of  very 
weak  Irradiation  soon  disappear.  Erythema  and  pigmentation 
are  the  first  to  go ;  often  enough  no  traces  of  these  are  left  after 
three  days.  Intumescence  of  the  skin  persists  longer,  and  to 
this  must  be  ascribed  the  excellent  appearance  of  the  integument 
in  the  earlier  period  after  the  suspension  of  treatment.  Weeks 
or  months  later,  when  the  skin  has  returned  absolutely  to  the 
normal,  one  may  be  able  to  recognise  slight  wrinkles  and  atro- 
phic spots — shewing  that  the  irradiation  had  been  a  little 
stronger  than  was  perhaps  thought  at  the  time,  and  that  it  had 
consequently  left  certain  permanent  changes  behind  it.  Where, 
however,  the  strength  of  the  irradiation  has  been  correctly 
gauged  and  administered,  the  excessive  glossiness,  elasticity,  and 
smoothness  of  the  exposed  region  disappear,  leaving  a  skin 
which  looks  thoroughly  healthy  and  normal. 

Six  to  eight  weeks  after  the  commencement  of  reaction  new 
hairs  begin  to  shew  themselves  in  the  smooth  and  hitherto  hair- 
less skin;  these  hairs  soon  grow  to  the  ordinary  size.  It  is  only 
after  long  and  intermittent  treatment  that  the  hairs  remain  in  a 
rudimentary  condition,  being  white  and  small,  with  superficially- 
lying  roots,  so  that  they  can  easily  be  pulled  out. 

Where  very  pronounced  erythema  (with  or  without  excoria- 
tion) has  been  induced,  this  condition  lasts  for  several  days; 
after  this  time  we  find  a  drying  up  of  the  normal  secretions, 


TREATMENT  JFITH  X-RAYS  339 

thickening  of  the  cuticle,  and  marked  pigmentation.  Then, 
when  the  swelling  has  subsided,  the  skin  exfoliates  very  freely. 
In  more  severe  types  of  Roentgen  dermatitis,  with  definite 
ulceration,  the  well-pronounced  inflammatory  phenomena  are 
accompanied  by  pain  and  occasionally  febrile  symptoms  for 
6-8  weeks.  After  this  time  the  after-effects  of  the  X-rays  seem 
to  be  completed  (note  that  hair  begins  to  grow  again  at  the 
expiration  of  6  to  8  weeks  also). 

The  X-ray  ulcer  has  Intensely  red,  sharp-cut  borders,  and 
heals  but  slowly  towards  the  centre.  The  ulcer-secretions  have 
a  tendency  to  dry  and  form  large  rupia-llke  crusts  adhering 
closely  to  the  base  of  the  ulcer;  on  removing  these  crusts  one 
sees  the  characteristic,  profusely-discharging  Roentgen-ulcer; 
pain  gives  way  later  to  a  feeling  of  Intense  Itching.  When  the 
ulcer  is  finally  healed  (and  this  may  take  a  year  or  more  In  very 
severe  cases),  the  scar  is  smooth,  flat,  and  of  good  appearance, 
or  it  may  be  sclerodermatous  or  atrophic.  Sometimes  telan- 
giectases appear  In  the  scar,  either  in  the  form  of  thick  branch- 
ing vessels  or  as  a  reddish  "marbling."  An  ulcer  healed  in  this 
manner  Is  liable  to  again  break  down  and  take  a  still  longer 
time  in  healing.  Besides  this  acute  fulminating  form  of  Roent- 
gen-dermatitis, however,  we  meet  with  another  and  milder  form. 
The  latter  Is  seen  after  prolonged  irradiation  with  weak  tubes 
(hard  tubes),  a  long  tube-distance,  and  short  exposures.  I'he 
dermatitis  then  runs  a  milder  course;  the  visible  signs  of  reac- 
tion are  less  pronounced  than  in  the  preceding  form.  They 
have  more  the  appearance  of  a  chronic  eczema,  such  as  is  seen 
in  laundrywomen — the  skin  is  swollen,  dry,  boardlikc,  thickly 
scaling,  and  in  places  excoriated  or  ulcerated.  One  often  sees, 
moreover,  an  atrophic,  cigarette-paper-like  change  in  the  skin 
and  nails.  Sensibility  Is  of  course  disturbed  In  these  cases  where 
the  hands  arc  affected.  Cases  of  this  kind,  the  so-called 
"chronic  radio-dermatitis,"  may  lead  to  the  same  cicatricial  or 
atrophic  conditions  as  the  acute  form. 

The  author  finds  himself  unable  to  agree  with  Oiidiii's  dic- 
tum that  Roentgen-ulcers  have  some  tendency  to  become  the  seat 
of  secondary  infection.  Antiseptic  dressings  would  in  any  case 
negative  possibilities  of  this  kind.     Still  many  writers  appear  to 


340  RADIO-THERAPY 

have  discovered  numerous  bacteria  in  their  histological  examina- 
tions of  the  ulcers. 

As  before  mentioned,  Roentgen-irradiation  of  the  hands 
often  brings  about  changes  in  the  nails.  These  become  dry, 
fissured,  thickened  and  distorted;  the  ridges  are  deepened  or 
become  thinner,  atrophic,  and  disappear  where  the  action  has 
been  very  strong. 

Numerous  reports  are  to  hand  concerning  the  histological 
changes  in  the  tissues  after  irradiation. 

Darier^)  noted  an  extension  of  the  prickle  and  horn-cell 
layers,  partly  due  to  general  hyperplasia  of  the  rete,  but  more 
particularly  to  increase  in  the  number  of  prickle  and  horn  cells 
themselves;  further,  a  thickening  of  the  epidermis,  great  increase 
of  keratohyalin,  and  degeneration  and  atrophy  of  the  hair- 
follicles,  hairs,  and  glands  of  the  skin. 

Unna  ")  found  slight  increase  of  the  nuclei  of  the  papillae 
and  round  the  blood-vessels,  and  copious  pigmentation  in  the 
upper  layers  of  the  cutis,  whereas  the  pigment  in  the  epidermis 
was  not  increased.  The  collagenous  layers  of  the  cutis  appeared 
much  thickened,  swollen  and  pressed  together,  so  that  the  inter- 
vening lymph-spaces  were  scarcely  visible.  They  shewed,  more- 
over, a  peculiar  staining  reaction,  becoming  basophilic.  The 
protoplasmic  elements,  especially  the  epithelium  of  the  sweat- 
glands,  appeared  compressed  and  very  small.  The  elastic 
bundles  were  not  seen  by  ordinary  methods  of  staining,  and  sec- 
tions shewed  them  to  have  a  great  tendency  to  separate  from 
each  other  and  fall  away  in  small  fragments. 

In  Kibbe's  case")  the  stratum  lucidum  was  wanting,  and 
keratohyalin,  highly  coloured,  was  found  in  the  neighbourhood 
of  the  follicles.  The  cutis  was  richly  cellular,  and  marked  by 
vascular  dilation. 

Gilchrist*)  found  the  horn-layer  thickened,  copious  brown 
pigmentation  in  the  rete,  and  dilated  vessels  in  the  corium. 

Jiitassy's  investigations  have  already  been  quoted  (p.  277). 


*)  Monatschr.  f.  prakt.  Dermatol.,  Vol.  XXV,  1897,  No.  9. 

')  Deutsche  Medicinalzeitung,  March    18,  1898. 

*)  New  York  Med.  Journal,  Jan.  16,  1897. 

*)  Johns  Hopkins  Hosp.  Bulletin,   Feb.,  1897. 


TREATMENT  JVITH  X-RAYS  341 

Gassmaun  ' )  found  the  following  histological  appearances 
in  a  small  piece  of  blackened  tissue  taken  from  the  base  of  a 
deep  Roentgen-ulcer:  The  specimen  was  not  necrotic  in  the 
ordinary  sense,  but  consisted  of  different  properly  characterised 
and  well-staining  elements.  The  main  portion  was  formed  of 
collagenous  bundles  (white  connective-tissue  fibres),  normal  in 
appearance,  and  staining  readily;  their  nuclei  also  stained  well 
with  ordinary  methods.  In  places  were  seen  degeneration-forms 
of  peculiar  appearance  which  took  the  nuclear  stain.  Between 
the  nuclei,  leucocytes  and  mast-cells  were  copiously  distributed. 
Elastic  bundles  were  readily  shewn  with  orcein  or  by  fVeigert's 
method. 

Microscopic  examination  of  another  ulcer"-)  shewed  new- 
formed  granulation-tissue  which  was  in  part  skinned  over;  the 
lesion  could  in  no  wise  be  distinguished  from  other  types  of 
ulcer. 

The  vessels  of  the  cutis  and  sub-cuticular  region  shewed 
remarkable  pathological  changes  in  a  Roentgen-ulcer  2  months 
old;  there  were  seen  enlargement  and  vacuole-degeneration  of 
the  intima,  loosening  of  the  elastica,  vacuolisation  and  atrophy 
of  the  muscularis. 

The  walls  of  many  vessels  were  changed  into  a  swollen  mass 
and  completely  obliterated.  The  intima,  which  was  thickened 
and  possessed  many  swollen  endothelial  cells,  was  in  places 
raised  from  the  underlying  layer,  so  that  here  and  there  round 
spaces  were  evident  in  this  region.  The  greater  part  of  the 
lumen  of  the  vessel  was  occupied  by  this  twisted,  reticular,  and 
vacuole-containing  intima.  Long  bladder-like  nuclei  with 
nucleoli  were  visible,  especially  near  the  lumen,  which  could  be 
readily  recognised  as  endothelial  nuclei.  The  vacuoles  were 
either  apparently  quite  empty  or  filled  with  a  finely-bundled 
material ;  here  and  there,  moreover,  a  nucleus  was  seen.  Only 
the  larger  vessels  shewed  the  remains  of  a  much  unravelled, 
unequally  thick,  and  often  broken  elastica. 

The  muscularis  often  presented  a  honeycombed  appearance, 


')  Fortschritte,  Voi.  II,  H.  4. 
^)  Ibid.  Vol.  II,  H.  6. 


342  RADIO-THERAPY 

the  brown-coloured,  smooth,  cross-cut  muscle  fibres  with  their 
well-stained  normal  nuclei  being  separated  from  one  another  by 
many  vacuoles.  The  muscle-bundles  themselves  appeared 
atrophied.  (These  changes  are  very  similar  to  those  shewn 
in  Fig.  59.) 

This  vacuolisation  degeneration  affected  both  arteries  and 
veins,  but  was  not  equally  marked  throughout  the  section.  The 
fact  that  within  a  vacuole  one  often  found  a  cell,  a  muscle-fibre, 
or  a  nucleus,  made  it  not  improbable,  in  Gassmann' s  opinion, 
that  these  spaces  occupied  the  site  of  pre-existing  cells.  One 
might  suppose  that  round  the  cell  an  exudation  had  collected 
which  compressed  the  cell  and  so  made  it  atrophy. 

Besides  these  vascular  changes,  Gassmann  ^)  also  observed 
degeneration  of  the  sub-cutaneous  connective  tissue,  with  abnor- 
mal staining  reactions. 

Lion  ~)  found  in  his  sections  changes  in  the  vessel-walls  cor- 
responding to  those  described  by  Gassmann;  he  found  also 
vacuolisation  in  all  the  layers  of  the  epidermis  and  cutis;  the 
cell-elements  appeared  swollen  and  perforated.  He  also  found 
copious  hcemorrhages. 

Scholtz  found  the  following  changes  in  the  skin  of  a  hog's 
back;  he  excised  the  specimen  for  examination  7  days  after 
one  hour's  irradiation : 

"The  horn-layer,  raised  somewhat,  contains  here  and  there 
several  nucleated  cells.  The  granular  layer  is  merely  indicated; 
in  places  it  is  quite  atrophied.  The  prickle-cell  layer  is  much 
diminished,  and  the  prickle-cells  themselves  are  greately  altered. 
The  latter  are  swollen,  their  contour  badly  defined,  their  shape 
in  the  palisade-layer  broader.  The  protoplasm  is  diffusely 
stained  with  hsmotoxylin,  the  nucleus  is  only  faintly  stained, 
and  the  chromatin  is  seen  in  small  conglomerations  and  in  frag- 
ments. The  nuclei  are  in  great  part  swollen,  and  often  iriHented 
and  vacuolised.  Vacuoles  are  found  in  the  protoplasm,  espe- 
cially in  that  adjacent  to  the  nuclei. 

In  nearly  every  microscopic  field  are  to  be  seen  cells  with 


?  L.  c. 

")  VII  Congr.  d.  dcutschen  dermatol.  Gcsellsch.,  Brcslau,   1901. 


TREA  TMEN  T  J 1 7  77/  X-RAYS  343 

two  or  e\-en  three  amitotic  nuclei.  Mitosis,  on  the  other  hand, 
is  not  seen,  or  at  least  only  the  commencement  of  it.  All 
these  signs  of  degeneration  obtain  from  the  palisadc-layer  to 
the  horn-layer;  near  the  surface  the  contour  of  the  cells  is 
scarcely  more  e\ident  and  their  protoplasm  has  become  almost 
a  homogeneous  mass;  the  nuclei  are  in  great  part  only  faintly 
indicated.  7  he  cell-changes  in  the  hair  root  sheaths  are  quite 
similar;  the  loosening  and  falling  of  the  hair  can  be  readily 
explained  by  this  cell-degeneration. 

The  corium  is  somewhat  a>dematous;  the  connective  tissue 
is  less  easily  strained,  somewhat  swollen  and  homogeneous. 
Unna's  "basophile"  reaction  is  not  obtainable  with  this  tissue. 
The  elastic  fibres  are  preserved.  The  connective  tissue  cells  have 
distinct,  more  or  less  diffusely  stained  protoplasm,  are  swollen 
and  often  peculiarly  shaped.  The  cells  of  the  sweat-glands  shew 
similar  mild  degenerative  changes,  proliferating  in  places  and 
projecting  into  the  lumen  of  the  ducts.  In  the  media  and  intima 
of  the  larger  vessels  also  are  seen  mild  forms  of  cellular  degen- 
eration, quite  similar  to  that  of  the  other  cells.  The  cells  of 
the  intima  are  swollen,  pressing  towards  the  lumen;  in  places 
they  are  manifestly  proliferating,  becoming  loosened  and  tend- 
ing to  mingle  with  the  blood-stream. 

In  sections  taken  from  a  more  powerfully  irradiated  skin  the 
cellular  degeneration  was  more  pronounced,  extending  to  the 
nucleus  as  well  as  to  the  body  of  the  cell;  besides  this  the  signs 
of  inflammatory  reaction  were  seen:  marked  \ascular  dilatation, 
serous  effusion  into  the  tissues,  conglomeration  of  leucocytes,  and 
free  migration  of  white  blood-corpuscles.  Where  a  high  degree 
of  cell-degeneration  is  attained  from  strong  irratliation  the  leu- 
cocytes collect  in  masses  round  ihe  dying  cells  and  so  aid  in  their 
complete  destruction.  Moreover,  many  "highly-charged" 
mast-cells  are  visible. 

The  cells  of  the  intima  and  media  of  the  blood-\-essels 
shew  changes  similar  to  those  described  by  Gcissninini. 

Round  the  hairs,  where  the  rete  extentls  towartls  the  cutis 
as  the  root-sheath,  quite  similar  tlcgeneratixe  processes  are  louiul 
among  the  cell-elements,   also   iiillanunatory   signs.      By   these 


344 


RADIO-THERAPY 


means    the    coverings   of    the    hair   are    completely    destroyed, 
masses  of  leucocytes  taking  their  place. 

In  the  severest  grades  of  reaction  microscopic  examination 
reveals  the  appearance  of  a  "Roentgen-slough."  The  rete  mal- 
phigii  and  the  horn-layer  are  completely  wanting;  in  their  place 
is  seen  a  zone  of  thickly  accumulated  and  mostly  well-formed 
polynuclear  leucocytes.     The  pus-cells  are  copious,  and  are  sur- 


FiG.  87. — (a)  Degenerated  swollen  cunnective-tissue  cells — "vacuolised  con- 
nective tissue."  (b)  Connective-tissue  cells  still  more  altered — giant-cell 
forms.  (From  W.  Scholtc  "Ueber  den  Einfluss  der  Roentgenstrahlen 
auf  die  Haut  in  gesundem  und  krankem  Zustande."  Archiv  f.  Dermatol, 
u.   Syph.,   Vol.  LIX,   Part  III.) 


rounded  by  line  thread-like  masses.  These  could  be  shewn  by 
Weigert's  method  of  staining  to  form  in  places  a  fine  network 
between  the  pus-cells.  Over  this  zone  of  leucocytes  lies  a  thin 
layer  composed  of  broken-up  pus  corpuscles,  nuclear  remains, 
detritus,  and  largely  of  masses  of  bacilli  and  cocci. 

Towards  the  cutis  the  zone  of  leucocytes  either  presents  a 
sharply-defined  border,   or   is  seen  penetrating  the  connective 


TREATMENT  JJ'ITH  X-RAYS  345 

tissue.  The  papillary  body  has  its  outline  comparatively  well 
preserved  for  the  greater  part,  or  is  at  least  recognisable.  The 
connective  tissue  is  soaked  with  serous  exudation,  swollen,  in 
parts  loosened  into  small  bundles.  The  elastic  network  is  pre- 
served; on  the  other  hand,  the  connective-tissue  cells  shew 
marked  degeneration:  the  protoplasm  is  swollen,  diffusely 
stained  by  hasmotoxylin,  containing  one  and  often  several  blad- 
der-like nuclei  of  peculiar  shape.  I'he  small  vessels  are  much 
dilated,  gorged  with  blood,  and  surrounded  by  leucocytes.  In 
the  zone  of  leucocytes  and  in  the  cutis  h;emorrhages  are  seen  of 
varying  size.  In  the  case  of  severe  Roentgen-ulcers  the  vessels 
of  the  cutis  and  sub-cutis  are  in  places  completely  obliterated, 
the  connective  tissue  \  acuolised  throughout,  the  connecti\e-tissue 
cells  forming  a  kind  of  giant-cell.    (See  Fig.  87.)" 

SclioUz  studied  the  process  of  healing  of  superficial  Roent- 
gen-ulcers in  several  specimens  taken  from  the  human  skin. 

"The  infiltration  in  the  corium  diminishes;  the  connective- 
tissue  cells  and  their  nuclei  become  normal  again,  and  where  the 
papillary  body  has  been  destroyed  it  becomes  replaced  by  fine, 
well-staining  connective-tissue  fibres  which  lie  parallel  to  the 
surface  of  the  skin.  The  epithelium  slowly  spreads  from  the 
borders  of  the  ulcer  and  soon  sends  processes  towards  the  still 
somewhat  oedematous  connective  tissue,  or  covers  over  the 
papillary  bodies  which  may  be  still  retained.  In  the  latter  event 
complete  restoration  of  the  normal  configuration  of  the  skin  is 
effected,  in  which  only  the  destroyed  follicles  are  wanting. 

Not  only  does  the  connective  tissue  in  the  healed  area 
remain  for  some  time  soft  and  wanting  in  strength,  but  the 
epithelial  cells  also  shew  signs  of  marked  disturbance  for  a 
while. 

The  rete  remains  (rdematous  for  some  time,  the  prickle- 
cells  swollen,  the  nuclei  bloated  and  badly-staining,  the  prickle, 
and  especially  the  granular  laver,  is  often  much  widened,  and 
the  keratohyalin  collectetl  in  lumps  and  particles  in  the  cells. 
In  the  honi-laycr  are  f'oiinti  nucleated  cells  in  w  liicli  tiic  horning 
process  is  incomplete.  Moreover,  in  cases  where  the  reaction 
has  not  reached  the  stage  or  excoriation  or  ulceration,  but  merely 
a  well-marked  dermatitis  has  shown  itself,  several  weeks  after 


346  RADIO-THERAPY 

the  irradiation  has  been  discontinued  and  all  inflammatory  phe- 
nomena hav^e  disappeared  similar  enlargement  and  changes  in 
the  prickle-cell  and  granular  layers  are  evident. 

It  is  quite  comprehensible  that  under  these  conditions  the 
newly  formed  Roentgen-scar  and  powerfully  irradiated  areas 
of  skin  should  be  very  sensitive  to  caustic  applications  or  to 
fresh  exposure  to  the  tube.  Weak  dressings  of  pyrogallol  oint- 
ment may  readily  cause  fresh  ulceration  of  the  whole,  and  these 
new  ulcers  may  be  very  slow  in  healing." 

The  destruction  of  the  cell-elements  and  especially  of  the 
connective-tissue  cells  is  probably  the  cause  of  the  tedious  repair 
of  Roentgen-ulcers,  since,  as  is  well  known,  scar-formation  pro- 
ceeds from  the  connective-tissue  cells. 

The  above-described  histological  changes  afford  a  ready 
explanation  of  the  falling  of  the  hair  after  Roentgen-radiation. 
The  rays  soon  take  effect  on  the  prickle-cell  layer  and  bring 
about  degenerative  changes  in  its  cell-elements ;  it  naturally  fol- 
lows that  the  cells  of  the  hair-sheaths,  in  which  the  cells  of  the 
rete  form  the  outer  layer  in  the  depth  of  the  cutis,  are  soon 
affected,  and  may  be  completely  destroyed.  This  only  happens 
where  a  certain  degree  of  intensity  in  the  irradiation  has  been 
attained,  whether  by  one  single  powerful  exposure  or  by  the 
accumulated  effects  of  several  weaker  exposures;  moreover,  it 
may  occur  without  the  rest  of  the  tissues  being  especially 
affected. 

Salomon^)  described  pronounced  changes  in  the  elastic 
fibres  in  a  case  of  lupus  treated  by  X-rays.  These  fibres  were 
quite  normal  in  the  deeper  layers  of  the  cutis;  more  superficially, 
however,  "innumerable  small,  very  fine  fibrils  were  seen,  which 
could  be  demonstrated  by  the  Uuna-Tdnzcr  or  JVeigcrt 
methods.  These  were  slightly  twisted,  often  wavy,  and  some- 
times lay  parallel  to  the  surface,  sometimes  vertically.  They 
increased  in  numbers  towards  the  surface  and  reached  to  the 
small-celled  infiltration  below  the  epidermis,  without  actually 
coming  Into  contact  with  the  epidermis  itself.  The  same  appear- 
ance was  manifest   in   the  thickened   adventitia   of  the  blood- 


')   Archiv.  f.  Derniat.  u.  Syph.,  Vul.  LX,  Part  II. 


TREATMENT  H^ITH  X-RAYS  347 

vessels,  but  here  the  fibres  lay  always  parallel  to  the  vessel- 
wall."     Clearly  these  were  very  young  elastic  fibres. 

Zehmann  ^)  examined  hairs  which  had  been  caused  to  fall 
by  Roentgen-radiation.  In  most  hairs  the  portion  of  the  shaft 
nearest  to  the  hair-root  was  considerably  thinner,  and  instead 
of  the  usual  bulbous  appearance  seen  in  the  root  itself  was  a 
thin,  pointed  remnant.  In  other  cases,  where  the  hair-shaft 
retained  its  usual  calibre,  in  place  of  the  bulb  a  stumpy,  conical 
end  was  seen.  Often  the  bulb  shewed  a  slight  swelling  at  the 
lower  end.  In  a  few  cases  hairs  were  found  having  well- 
marked  bulbs  with  a  peculiar  brush-like  condition.  In  view  of 
the  three  first-named  conditions,  Zehmann  considers  that  we 
have  to  deal  in  these  cases  with  a  rapidly  developing  atrophy  of 
the  hair-root,  reminding  one  in  some  ways  of  the  condition 
obtaining  in  alopecia  areata. 

The  prognosis  of  Roentgen-dermatitis  depends  upon  the 
following  factors :  the  intensity  of  the  irradiation,  the  extent 
and  depth  of  the  pathological  changes,  the  locality  affected. 
The  sooner  a  powerful  reaction  makes  its  appearance,  the  more 
severely  does  it  run  its  course,  and  the  worse  are  the  prospects 
of  early  cure.  As  a  rule,  dermatitis  and  ulceration  shew  a  ten- 
dency towards  improv^ement  after  about  two  months,  by  which 
time  in  ordinary  cases  the  after-effects  of  the  irradiation  have 
exhausted  themselves,  and  fresh  hairs  begin  to  make  their 
appearance.  Of  course  the  rapidity  of  healing  depends  largely 
upon  the  size  of  the  ulcer.  The  extent  of  the  scarring,  telan- 
giectasis, etc.,  which  may  follow,  depend,  moreover,  upon  the 
intensity  of  the  dermatitis  and  the  extent  to  which  the  tissues 
have  been  transformed.  These  after-conditions,  therefore,  are 
controlled  by  earlier  factors — the  intensity  of  the  treatment  and 
the  reaction.  The  appearance  of  a  white  patch  on  a  larger,  red, 
shallow  excoriation  is  a  bad  prognostic  sign;  this  indicates  later 
ulceration.  Ulcers  lying  o\cr  superficial  bony  prominences 
(the  chin,  vertebral  spines,  etc.)  are  especially  obstinate. 

The  treatment  of  these  affections  is  not  so  ineffective  as  is 
generally  supposed.     In  the  mildest  case,  marked  only  by  sub- 


*)  Frcund.  Wiener  med.  Woclicnsrhr..  1897,  No.   10. 


348  RADIO-THERAPY 

jective  symptoms,  the  application  of  a  dusting  powder  is  quite 
sufficient.  If  erythema  or  excoriation  be  present,  tepid  dress- 
ings of  boracic  lotion,  a  15%  boracic  lanolin,  or  diachylon  oint- 
ment, are  useful.  Oudin  recommends  peroxide  of  hydrogen 
dressings. 

Cold  applications  of  liquor  Burowii,  which  are  so  often 
recommended,  are  directly  harmful. 

The  author  repeatedly  observed  in  several  cases  of  hyper- 
trichosis under  treatment  by  X-rays  during  a  cold  winter  sea- 
son that  when  the  patients  reached  the  stage  of  reaction  the  skin, 
under  the  influence  of  the  extreme  cold,  became  darkly  cyanotic, 
so  that  the  patients  and  their  friends  became  not  a  little  alarmed. 
This  discolouration,  and  a  strong  burning  sensation  which 
accompanied  it,  disappeared  in  a  few  days.  Perhaps  the  con- 
dition is  to  be  referred  to  the  relaxing  effect  of  the  cold  upon 
the  blood-vessels. 

The  application  of  warmth  to  the  affected  regions  is  always 
acceptable  to  the  patient,  whether  in  the  form  of  hot  fomenta- 
tions, poultices,  or  otherwise.  The  author  recently  treated,  in 
conjunction  with  Prof.  Ehrmann,  two  cases  of  deep  Roentgen- 
ulceration  which  had  resulted  from  exposure  to  soft  tubes  by 
a  Viennese  practitioner;  radiant  heat  from  a  powerful  incan- 
descent lamp  (100  candle  power)  was  employed,  with  daily 
half-hour  sittings.  This  not  only  reheved  the  subjective  symp- 
toms, such  as  intense  itching,  but  rapidly  healed  the  sores.  The 
good  results  attained  in  these  two  cases  would  appear  to  speak 
well  for  the  method^).  Very  obstinate  ulcerations  should  be 
thoroughly  and  deeply  excised  and  a  plastic  operation  after- 
wards performed. 

Apostoli  and  Oudin  have  seen  good  results  from  the  employ- 
ment of  spark-discharges. 

The  pigmentation  left  after  irradiation  disappears  as  a  rule 
spontaneously  in  a  short  time.  Torok  and  Schcin  hasten  its 
departure  by  the  shaling  action  of  naphthol  ointment. 


')  The  author  heard  afterwards  that  Bar  had  achieved  good  results  in  the 
treatment  of  Roentgen-ulcers  with  red  light.  Referred  to  by  Oudin  at  the 
II  Congr.  internat.  d'filectrologie  et  de  Radiologic,  i  Sept.  1902. 


IV. 

BECQUEREL-RAYS. 


BECQUEREL-RAYS. 

§35.  This  is  the  name  given  to  a  physical  phenomenon, 
strikingly  similar  in  its  effects  to  the  X-rays,  which  was  discov- 
ered by  H.  Becquerd  in  1896.  Whilst,  however,  the  X-rays 
can  only  be  produced  by  the  aid  of  rather  complicated  appara- 
tus, in  which  electrical  processes  take  place,  the  Becquerel-rays 
require  no  physical  instrument  at  all.  They  are  emitted  by 
certain  chemical  elements  procured  usually  from  uranium  pitch- 
blend,  and,  so  far  as  is  at  present  known,  no  external  action 
on  the  substances  is  required  to  bring  about  their  emission. 
Neither  directly  nor  indirectly  is  any  electrical  apparatus  needed 
for  the  production  of  these  rays,  and  the  radiation,  for  some 
reason  still  unexplained,  goes  on,  undiminished,  without  any 
assignable  external  cause. 

Becquerel  found  that  not  only  uranium  salts,  but  also  metal- 
lic uranium  possesses  radio-activity.  Mme.  Slodkozvska  Curie 
proved  that  when  the  bismuth  is  eliminated  from  natural 
uranium  pitch-blend,  traces  are  found  of  a  substance  which  gives 
out  Becquerel-rays  of  great  intensity.  This  substance  M.  and 
Alme.  Curie  called  polonium.  A  second  radio-active  constitu- 
ent of  pitch-blend  is  found  combined  with  barium;  this  is  called 
radium.  Debierne  discovered  yet  another  substance  with  radio- 
active properties  in  pitch-blend;  this  he  called  actinium. 
Thorium,  too,  and  its  combinations  have  been  found  to  be  radio- 
active. Afanasjew  and  Crookes  discovered  that  all  minerals 
containing  radium  and  thorium  are  more  or  less  radio-active, 
even  when  extremely  minute  quantities  of  these  elements  are 
present.  According  to  ElsWr,  many,  indeed,  perhaps  all, 
bodies  present  on  the  surface  of  the  earth  emit  Becquerel-rays. 
The  radiation  of  polonium,  of  the  radio-active  lead  discovered 
by  K.  A.  Hofmann  and  E.  Slrauss,  and  of  other  radio-active 
substances,  falls  off  markedly  in  course  of  time,  but  sulphate  of 
lead  is  said  to  regain  the  power  under  the  influence  of  cathode- 


3  5  2  RADIO-  THERAPY 

rays;  the  elementary  nature  of  these  substances  is  a  matter  of 
doubt,  and  it  is  surmised  that  they  owe  their  activity  to  induced 
radiation  or  to  incorporated  traces  of  radium  or  actinium, 
which  permanently  retain  their  activity.  Bt'cquerel,  for 
Instance,  found  that  a  non-active  body  brought  near  to  an  active 
body  and  exposed  for  some  days  to  irradiation  from  the  latter. 
Itself  becomes  for  some  time  radio-active. 

Ehter  and  Geitel  have  lately  proved  that  in  the  atmosphere 
too,  particularly  where  (as  In  enclosed  spaces)  it  is  seldom 
renewed,  some  radio-active  substance  is  present,  which  diffuses 
electricity  In  the  atmosphere. 

It   Is  exceedingly   difficult   to   procure   these   radio- 
active preparations.     Herr  Giesel  told  the  author  that 
from   8oo   grammes  of   raw  material  he   gained  only 
0.3  gram  of  radio-active  substance.    Hence  these  prep- 
arations   are    very    costly.     Von    Lengyel    lately    suc- 
ceeded in  obtaining  synthetically  radio-active  substances 
(sulphate,  chloride  and  carbonate  of  barium). 
A  distinctive  mark  of  radio-active  salts  is  their  self-lumi- 
nosity.  They  phosphoresce  unlntermittenly,  without  any  preced- 
ing illumination,  by  means  of  their  own  rays,  which  proceed 
from  the  depths  of  their  own  substance.       Giesel  found  this 
quality  specially  marked  in   active  bromide  of  barium,    freed 
from  water.      The   luminosity  of   radio-active   substances   dis- 
appears when  they  are  warmed  and  re-appears  as  they  become 
cold. 

Becquerel-rays  blacken  a  photographic  plate;  like  the 
cathode-rays  {Becquerel,  Goldstein) ,  they  produce  certain  after- 
effects of  colour  on  rock-salt,  chloride  of  potassium  and  fluorlte; 
and,  like  the  X-rays,  they  colour  glass  violet  {Villari,  Berthe- 
lot) .  M.  and  Mme.  Curie,  Berthelot  and  Becquerel  found  other 
chemical  effects  of  Becquerel-rays.  Thus,  they  Impart  ozone  to 
the  air,  and  darken  barium  platino-cyanide,  and.  In  presence  of 
oxalic  acid,  reduce  corrosive  sublimate  to  calomel.  Further 
points  of  similarity  between  the  cathode-,  Becquerel-,  and 
X-rays  were  proved.  Thus,  P.  Bary  found  that  all  the  chemi- 
cal compounds  which  are  made  luminous  by  the  X-rays  become 
ohosphorescent  also  through  the  others.     According  to  Him- 


RECO  UEREL-RA  YS  353 

stedt,  both  kinds  of  rays  lessen  the  resistance  of  selenium-cell; 
the  property  of  ozonizing  the  air,  too,  is  common  to  both 
cathode-  and  Becquerel-rays.  The  best  known  peculiarity  of 
these  rays  is  their  power  of  passing  through  dark  opaque  bodies 
(metals,  too,  with  the  exception  of  lead),  and  then  acting  on  a 
photographic  plate  or  a  fluorescent  screen.  Becquerel-rays, 
howev^er,  differentiate  less  than  the  Roentgen-rays.  A  metal 
object  enclosed  in  an  opaque  cov^ering  is  recognisable  on  the 
luminous  screen  and  on  the  photographic  plate,  but  not  so  the 
bones  of  the  hand. 

With  suitable  experimental  conditions  the  Becquerel-rays 
have  a  similar  electric  action  to  the  short-waved  light  rays;  thus 
they  impart  a  certain  electrical  conductivity  to  gas  permeated 
by  them  ^) . 

Geitel  holds  that  air  in  a  normal  condition  has  some  slight 
conductivity,  which  is  raised  by  the  merest  trace  of  a  radio-active 
substance.  When  radio-active  substances  have  been  kept  in  any 
room  the  walls  for  a  long  time  after  radiate  radium  rays 
(induced  radiation)  and  ionize  the  air,  so  that,  for  experiments 
on  the  normal  conductivity  of  the  air,  it  is  necessary  to  work 
in  places  where  it  is  certain  that  no  radio-active  substances  have 
been  stored. 

The  rays  of  radio-active  substances  are  capable  of  discharg- 
ing a  charged  electroscope;  the  brush  and  spark-discharge  of  an 
induction-apparatus  between  a  sphere  (as  anode)  and  a  disc 
(as  cathode)  is  converted  into  a  glow-discharge.  Becquerel- 
rays  possess  this  peculiarity  to  such  an  extraordinary  degree 
that  it  may  be  used  to  prove  the  presence  of  very  feeble  rays, 
and  of  the  rays  of  those  bodies  which  preserve  their  radio-activ- 
ity for  a  short  time  only.  Under  the  influence  of  Becquerel- 
rays  the  delaying  of  the  process  of  spark-discharge  (discovered 
by  Jaumann)  is  suspended 

Giesel,  V.  Scliweidler,  and  St.  Meyer  regarded  the  deflec- 
tivity  of  these  rays  in  the  magnetic  Held  as  a  negative-electricity 


')  According  to  St.  Mryrr  and  /',  t-.  Sclwridlrr.  tlif  con.lnclivity  nf  llir 
air  irradiated  by  Bccqucrcl  rays  is  diminished  hy  tlie  presence  of  a  niagnelic 
field. 


354  RADIO-THERAPY 

movement.  This  behaviour  in  the  magnetic  field  points  to  the 
deflectible  rays  carrying  with  them  negative  electrical  dis- 
charges. In  the  electrostatic  field,  too,  as  is  seen  from  Bec- 
querel's  and  Dorn's  experiments,  they  are  movable.  It  has  been 
concluded  from  this  behaviour,  and  from  other  qualities  in  har- 
mony with  it,^)  that  the  rays  proceeding  from  the  radio-active 
substances  are  physically  identical  with  cathode-rays,  and  that 
they  owe  their  origin  to  the  emanation  from  the  radio-active 
bodies  of  very  minute  particles. 

The  rays  proceeding  from  radio-active  bodies  are  not  homo- 
geneous, but  are  of  several  kinds,  quite  distinct  in  character,  which 
vary  in  their  power  of  penetration  {f Falter) ,  in  their  behaviour 
in  the  magnetic  field  {P.  and  S.  Curie,  Becquerel,  Villard, 
Giesel,  St.  Meyer,  and  others),  and  in  their  physiological  action 
on  the  eye  and  the  skin  {Aschkinass,  and  the  writer).  It  has 
been  shown  that  besides  the  rays  which  undergo  distinct  deflec- 
tion in  the  magnetic  field  and  have  great  penetrating  power, 
whose  co-efficient  of  absorption  diminishes  as  the  thickness  of 
layer  increases,  radium,  uranium,  and  GieseVs  polonium  emit 
other  rays  very  similar  to  the  X-rays.  These  rays,  like  X-rays, 
are  not  affected  by  a  magnetic  field,  and  have  far  less  pene- 
trating power  than  those  In  the  first  group;  their  co-efficient  of 
absorption  increases  with  the  thickness  of  the  layer.  Dorn  dis- 
covered the  remarkable  circumstance  that  rays  not  magnetically 
deflectible  are  converted  almost  wholly  Into  magnetically  deflec- 
tible rays  by  passing  through  paper,  and  partially  so  by  passing 
through  aluminium. 

The  wave-length  of  the  Becquerel-rays  has  not  yet  been 
determined;  It  Is  surmised  that  It  is  far  less  than  that  of  the 
Roentgen-rays  (calculated  at  0.0014  micron).  Their  velocity 
has  been  calculated  by  Kaufmann  at  about  250,000  km.  per 
second.  This  is  not  very  different  from  the  velocity  of  light 
(310,000  km.),  and  that  of  cathode-rays  (280,000   km.)^). 

^)  For  instance,  they  evoke,  like  cathode-rays,  the  thermo-luminosity  of 
fluorspar,  which  previous  heating  has  destroyed. 

")  Many  of  the  facts  given  here  are  taken  from  Dr.  /.  Elster's  compre- 
hensive references  in  Dr.  /.  M.  Eder's  Jahrbiicher  fiir  Photographic  u.  Re- 
produktionstechnik  (for  igoo,  1901,  1902),  to  which  the  reader  is  referred 
for  fuller  information. 


BECQUEREL-RAYS  355 

§36.  As  has  been  already  mentioned,  certain  biological 
effects  of  Becquerel-rays  have  become  known  to  us.  We  are 
acquainted  mainly  with  their  influence  on  the  skin  and  the  eye, 
and  on  bacteria. 

According  to  Henri  Becqitercl,  the  germinating  power  of 
seeds  is  destroyed  by  prolonged  irradiation. 

Two  Italian  investigators  were  the  first  to  report  an  action 
of  the  rays  of  radio-active  substances  on  micro-organisms. 
Pacinotti  and  Porcelli'^)  found  that  various  germs  could  be 
killed  within  3  to  24  hours  by  the  rays  emitted  by  a  freshly 
obtained  powder  of  metallic  uranium,  which  had  been  exposed 
to  sunlight  and  then  cooled  down  to  a  temperature  of  44-55 
degrees  in  a  receptacle  from  which  the  air  was  excluded.  The 
microscope,  it  was  averred,  showed  distinct  changes  in  these 
germs,  which  could  only  be  ascribed  to  chemical  action  on  their 
protoplasm. 

Experiments  were  made  in  this  way  on  staphylococci  and 
streptococci,  proteus,  and  cholera  germs,  also  on  the  bacilli  of 
tuberculosis,  diphtheria,  and  typhus.  Five  ccm.  of  a  very  poi- 
sonous broth  culture  of  streptococcus  were  injected  under  the 
skin  of  both  ears  of  a  rabbit,  and  one  ear  was  exposed  to  the 
action  of  the  uranium  rays.  No  inflammation  at  all  resulted  in 
the  irradiated  ear,  whilst  in  the  other  ear  the  local  affection  took 
its  ordinary  course. 

The  present  writer  in  the  beginning  of  1900  made  some 
experiments  with  a  view  to  testing  the  possible  bactericidal 
power  of  Becquerel-rays -).  In  his  investigations  he  used  the 
salts  of  metallic  uranium,  not  uranium  itself.  M.  and  Mme. 
Curie  had  observed'')  that  both  natural  pitch-blend  and  the 
bismuth  and  barium  compounds  obtained  from  it  are  considera- 
bly more  active  than  metallic  uranium  itself.  Of  the  two  sub- 
stances (radium  and  polonium),  three  preparations  of  radium 
were  at  the  author's  disposal.  The  first  was  a  few  grains  of  the 
original  preparation  of  M.  and  Mme.  Curie  of  Paris,  which 


^)  Gazctta  degli  Ospcdali,   ref.   to  in   Wiener  mcd.   Blatter,    1899,   No.   I, 

p.  15- 

')  Die  physiologischcn   VVirkiniKi'ii  der  Polcntladungc-n,  etc.,   1.  c. 

•)  Compt.  rend.,  1898,  CXXVII,  pp.   175,  i^i5- 


356  RADIO-THERAPY 

Dr.  St.  Meyer  of  Vienna  most  kindly  lent  him  for  purposes  of 
experiment.     The  two  other  radio-active  substances  A  and  B 
came  from  the  laboratory  de  Haen  at  List,  near  Hanover,  where 
they  had  been  prepared  according  to  the  directions  of  Herr  A. 
de  Haen.     A  differs  from  B  in  being  self-luminous  to  a  greater 
degree;  B,  on  the  other  hand,   stimulates   fluorescence  in   the 
barium-platinum-cyanide  screen  much  more  than  A  does.    Sev- 
eral grains  of  both  A  and  B,  thanks  to  the  kindness  of  Hofrath 
Prof.  Dr.  /.  M.  Eder,  director  of  the  Imperial  Graphischen 
Lehr-u-Versuchsanstalt,  were  procured  and  set  aside  for  experi- 
ment.   In  the  first  place  Dr.  St.  Meyer  established  the  fact  that 
both  A  and  B  had  the  same  electric   qualities   as  the   Curie 
preparation.     As  the  substances  are  extremely  hygroscopic  and 
lose  something  of  their  strength  on  contact  with  the  air,  each 
of  the  three  preparations  was  first  wrapped  in  a  small  covering 
of  parchment  paper,  and  this  again  enclosed  in  an  envelope  of 
fairly  thick  aluminium  foil,  any  gaps  being  closed  with  a  cement 
impervious  to  air  and  moisture.     These  covers  of  paper  and 
aluminium  apparently  offered  no  obstacle  to  the  passage  of  the 
rays,  as  could  be  easily  seen  from  tests  with  the  barium-platinum- 
cyanide  screen.    They  were  marked  on  the  outside  A,  B  and  C. 
On  the  agar  plates  {a,  b  and  c)  diffused  cultures  of 
staphylococcus  pyogenes  aureus  were  made;  on  the  cen- 
tre of  each  dish  a  piece  of  sterilized  paper  was  spread, 
and  on  these  again  the  substances  A,  B  and  C  were  laid. 
They  were  left,  each  on  its  respective  dish,  for  3  hours, 
and  at  the  end  of  that  time  both  they  and  the  papers 
were  removed  and  the  dishes  put  in  the  incubator. 

After  24  hours  all  three  cultures  showed  a  quite  even 
growth,  without  any  interruption  of  luxuriantly  develop- 
ing colonies. 

The  experiment  was  repeated,  with  the  modification 
that  the  Irradiation  was  left  to  work  for  3  days  instead 
of  3  hours. 

The  result  was  again  a  wholly  negative  one.  The 
subject  of  the  next  experiment  was  a  micro-organism  of 
less  resisting  power,  viz.,  the  typhus  bacillus.  The 
experiment  was  arranged  like  the  preceding  one. 


BECQ  UEREL-RA  YS  3  5  7 

In  this  case,  too,  even  after  3  days'  action  of  the 
rays  on  the  cultures,  there  was  not  the  sHghtest  evidence 
of  any  influence  on  the  growth. 

These  experiments,  undertaken  for  the  purpose  of 
showing  any  possibly  existing  power  of  the  Becquerel 
rays  to  kill  bacteria,  already  developed  and  capable  of 
life,  were  carried  on  by  the  author  in  precisely  similar 
fashion  to  the  methods  he  adopted  in  his  experiments 
on  spark-discharges. 
These  experiments  too  yielded  a  negative  result,  and  justify 
us  in  the  conclusion  that  Becquerel-rays  of  the  quality  and  inten- 
sity available  for  enquiry  are  not  in  any  way  capable  of  checking 
the  development  and  life  of  bacteria. 

With  regard  to  the  action  of  Becquercl-rays  on  the  skin, 
observed  by  GiescI,  M.  and  Mme.  Curie,  and  others,  when  the 
preparations  were  used  under  other  experimental  conditions,  the 
author  surmised^)  that  radium  preparations  emit  various 
classes  of  rays,  of  which  some  are  more  biologically  active  than 
others. 

This  surmise  is  confirmed  by  the  result  of  experiments 
reported  by  Aschkinass  and  Caspari.  These  writers  made 
experiments  on  the  bactericidal  properties  of  Becquerel-rays 
with  a  very  powerfully  radio-active  preparation  of  barium- 
radium-bromide,  investigating  first  the  action  of  the  non-absorb- 
able  rays  which  had  passed  through  aluminium  foil. 

Results  were  absolutely  negative;  the  bacteria  developed 
under  the  action  of  these  rays  just  as  they  did  without  irradia- 
tion. But  when  the  absorbable  Becquerel-rays  were  examined, 
the  result  was  positive;  the  easily  absorbable  rays  checked  the 
development  of  the  bacteria  on  an  agar  plate,  the  organism 
growing  luxuriantly  in  the  part  on  which  no  rays  fell.  Asch- 
kinass and  Caspari  proved  by  special  control  experiments  that 
bacterial  development  was  checked,  not  by  the  air  changed 
(ionized)  by  the  Becquerel-rays,  nor  by  the  bromine  freed  from 
the  bromide,  but  solely  by  the  easily  absorbable  rays  falling  on 
the  bacteria.     Where  these  rays  had  to  pass  through  a  thicker 


')   Naturforscherversammlung,  Hamburg,  igoi. 


358  RADIO-THERAPY 

stratum  of  air  before  they  reached  the  agar  plate  no  effect  was 
seen ;  the  effective  rays  had  been  absorbed  by  the  air  ^) . 

Strebel,  too,  reported")  experiments  with  positive  results; 
according  to  him  bactericidal  action  is  sometimes  present,  some- 
times not. 

Quite  lately  the  author  was  again  in  a  position  to 
make    some    experiments,    with    a    radium    preparation 
made  by  Herr  Saubermann  of  Berlin.    This  time  he  did 
not  use  an  aluminium  covering,  but  enclosed  the  prepa- 
ration in  parchment  paper  only;  in  spite  of  this  the  result 
was    negative,    after    the    bacteria    culture    had    been' 
exposed  as  close  as  possible  to  the  rays   for  3   days. 
.This  preparation  too,  therefore,  emitted  rays  too  weak 
to  act  on  the  bacteria. 
The  writer,  simultaneously  with  these  experiments  on  bac- 
teria, made  the  first  experimental  investigation  of  the  action  of 
Becquerel-rays  on  the  skin. 

The  3  aluminium  envelopes  were  enclosed  side  by 
side  in  a  gutta-percha  paper,  and  this  was  made  adhesive 
with  chloroform  and  applied  to  the  outer  aspect  of  the 
upper  arm.     The  whole  was  bound  closely  to  the  arm 
with  a  bandage.     For  3  days  the  little  packet  was  left 
on  the  same  spot.     At  the   end  of  this  time   it  was 
removed,  when  the  skin  did  indeed  show  some  redness, 
but  so  slight  that  it  seemed  to  the  author  more  probable 
that  this  had  come  from  the  rubbing  and  the  irritation 
of  the  gutta-percha  paper  than  from  any  action  of  the 
rays. 
Groiiven  too  made  experiments  on  himself  with  a  radio- 
active preparation.     This  was  bound  on  the  arm  for  12  and 
36  hours;  after  6  weeks  there  was  still  no  sign  of  reaction^). 
On  the  other  hand,  Walkhoff^)  observed  an  action  of  the 
Becquerel-rays  on  the  human  skin  exactly  corresponding  to  that 
of  the  X-rays. 


')  PnUger's  Arch.  f.  Physiologic,  1901,  Vol.  LXXXVI,  pp.  603  ff. 
")  73-  Versammlung  der  Natiirforscher  und  Aerzte  in  Hamburg. 
^)  Versamml.  der  Natiirforscher  und  Aerzte  in  Hamburg. 
*)  Phot.  Rundschau,  XIV,  p.  189. 


BECO  UEREL-RA  YS  359 

On  February  19th,  1901,  Dr.  G'lcscl  told  the 
author:  "'fValkhoff  laid  on  his  arm  for  20  minutes  on 
two  occasions  0.2  grm.  of  a  preparation  of  mine  in  a 
double  celluloid  capsule.  After  14  days  the  skin  became 
violently  inHamed.  The  spot  was  still  reddish  brown 
after  six  months,  and  is  even  yet  distinguishable.  By 
mistake  I  applied  to  myself  for  two  hours  0.3  grm.  of 
a  more  powerfully  active  preparation.  At  first  there 
was  only  faint  redness,  but  after  2  to  3  weeks  violent 
dermatitis  set  in,  followed  by  blistering  and  destruction 
of  the  epidermis  as  after  a  burn.  At  this  time  the 
exactly  circumscribed  spot  looked  so  bad  that  I  put  myself 
under  medical  treatment  (Dr.  Stcrnthal),  fearing  that 
the  destruction  of  tissue  might  extend  deeper.  Two  or 
three  days  after  that  the  place  began  to  heal,  and  in  two 
days  more  the  skin  had  formed  all  over  it;  only  a  rough- 
ness was  left  for  some  time.  The  place  now,  after  about 
three  months,  is  faintly  indicated  by  the  absence  of 
hairs. 

"I  was  the  first  to  find  that  radium  reacts  also  on 
the  living  plant  leaf  after  contact  for  a  few  hours;  the 
chlorophyll  disappears  after  some  days,  and  months 
later  the  spot  is  still  recognisable  by  the  autumnal- 
yellow  colouring  of  the  whole  leaf  and  the  brownish 
spots  on  the  surface. 

"Even  the  best  preparations  have  absolutely  no  effect 
on  bacteria,  as  Jl'cilk/iojf  has  proved  in  the  Munich 
Physiological  Institute. 

"To-day  a  medical  man,  who  wanted  to  experiment 
on  the  eye  with  one  of  my  preparations,  assured  me 
that  he  had  not  been  able  to  observe  the  slightest  bac- 
tericidal properties  on  the  part  of  radio-active  bodies." 
Dr.  A.  Sternthal,  who  had  treated  Dr.  Gicsi'l  for  this  der- 
matitis, reported  at  the  Breslau  Congress  of  Dermatologists  ') 
that  in  the  site  of  the  Inflammation  a  smooth,  white,  somewhat 
dej3ressed  scar  was  to  be  seen,  with  more  colour  round  Its  bor- 


')  Vcrhandlungsbcriclit,  \).  480. 


36o  RADIO-THERAPY 

ders.     The  spot  was  absolutely  hairless,  whilst  hairs  grew  all 
round  about  it  on  the  arm. 

M.  P.  Curie  made  several  interesting  experiments, 
based  on  those  of  Giesel  on  himself,  with  a  preparation 
the  activity  of  which  was  about  9,000  times  as  powerful 
as  that  of  uranium. 

Curie  gave  the  author  the  following  particulars  of 
the  experiments:  August  ist,  1901.  "I  allowed  the 
preparation  to  act  on  my  arm  for  10  hours.  It  was 
separated  from  the  skin  by  a  thin  layer  of  gutta-percha, 
and  held  firmly  in  place  by  a  bandage,  for  it  is  necessary 
that  the  substances  should  be  very  close  to  the  skin  and 
be  only  separated  from  it  by  very  thin  media.  The 
action  under;  such  experimental  conditions  was  more 
powerful  than  I  desired,  for  even  now,  4  months  after 
the  irradiation,  the  wound  is  not  yet  healed. 

"Stronger  preparations — and  we  possess  some 
1,000,000  times  more  powerful  than  uranium — act 
from  a  distance  and  through  glass,  and  an  exposure  of 
10  minutes  suffices  to  produce  inflammation  of  the  skin. 
The  reaction  sometimes  does  not  show  itself  until  19  and 
even  30  days  after  irradiation." 

Becquerel  put  into  a  glass  tube  i  cm.  long  and  3  mm. 
in  diameter  a  few  decigrams  of  radium-barium  chloride, 
which  has  considerable  radio-activity,  surpassing  that  of 
metallic  uranium  about  800,000  times.  The  glass  tube 
was  hermetically  closed,  wrapped  in  paper,  and  put  in 
a  little  cardboard  box.  On  the  3rd  and  4th  of  April 
this  box  was  repeatedly  put  into  the  pocket^of  the  waist- 
coat worn  by  the  experimenter.  The  latter  kept  it  in 
his  pocket  for  perhaps  6  hours  in  all.  On  the  13th 
of  April  he  noticed  that  the  rays,  which  had  traversed 
the  glass  tube,  the  wrapping  paper,  the  cardboard  of  the 
box  and  the  clothes,  had  produced  on  the  skin  of  the 
body  a  red  oblong  patch,  6  cm.  long  and  4  cm.  broad. 
On  the  24th  of  April  the  skin  peeled,  and  the  most 
severely  affected  part  began  to  suppurate  and  discharge 
fragments  of  necrotic  tissue.     The  wound  did  not  heal 


BECQUEREL-RAYS  361 

until  49  days  after  the  rays  had  acted.  Thirty-four 
days  after  the  experiment  dermatitis  of  a  less  violent 
nature  showed  itself  also  in  a  second  part,  corresponding 
to  the  other  end  of  the  waistcoat  pocket,  to  which  the 
glass  tube  had  probably  got  shifted  for  a  time.  Mme. 
Curie,  who  had  carried  a  few  centigrams  of  the  same 
radio-active  substance  in  a  glass  tube  from  one  place  tu 
another,  had  similar  inflammation  on  her  hand,  though 
the  glass  tube  was  enclosed  in  a  case  (which  had  very 
thin  sides).  P.  Curie  and  Becquerel  further  report') 
that  in  the  course  of  their  experiments,  beside  the  above- 
mentioned  lesions,  they  suffered  from  peeling  of  the  skin 
of  the  hands,  and  at  the  tips  of  the  fingers,  with  which 
they  had  carried  the  little  tubes,  from  very  painful  spots, 
which  caused  trouble  for  some  time. 

Aschkinass   notes  -)    the    interesting    fact   that   the 

power  of  the  Becquerel-rays  is  not  lessened  when  the 

preparations  are  allowed  to  act  on  the  skin  packed  in 

aluminium  capsules. 

Giesel  discovered')  that  the  Becquerel-rays  act  on  the  eye. 

If  a  radium  preparation  is  wrapped  in  light-proof  paper  and 

brought  in  the  dark  near  to  the  closed  eye  an  intense  sensation 

of  light  is  felt.     This  is  strongest  when  the  preparation  is  laid 

on  the  lid,  but  it  is  still  very  clearly  perceptible  when  the  hand 

is  interposed  or  the  preparation   brought  near   the   temporal 

region.     According  to  Giesel,  this  phenomenon  is  probably  due 

to  some  phosphorescence  in  the  interior  of  the  eye. 

GieseVs  results  have  been  substantiated  by  numerous  other 
investigators  also.  M.  Maier*)  reported  radium  rays  as  not 
acting  on  the  normal  eye,  but  this  theory  is  contradicted  by  the 
observations  of  all  the  other  investigators. 

F.  Himstedt  and  JV.  A.  Nii;^cl  have  subjected  to  closer 
examination  Giesel's  discovery  of  the  light-sensation  produced 


')  Acad,  de  Sc,  June  1,3th,  190T. 

^)  7?>-   Vcrsammliing  deutschc-r  Natiirforschcr  und   Acrztc  in   Hamburg. 

')  Physik.  Zcitschr.,  1899.  No.  3.  P-  43- 

*)  Bleiblatter,  etc.,  24,  1900,  p.  I344- 


362  RADIO-THERAPY 

on  the  eye  by  Becquerel-rays  ^) .  They  confirm  his  experience 
only  in  the  case  of  an  eye  adapted  to  the  dark,  just  as 
Roentgen-rays  and  ultra-violet  light  can  only  be  perceived  by  a 
completely  rested  eye.  It  was  not  possible  to  determine  whether 
the  Becquerel-rays  act  directly  on  the  light-perceiving  organs 
of  the  retina,  rods  or  cones,  as  they  produce  fluorescence  (which 
acts  as  a  diffused  light  source  on  the  eye)  in  the  transparent 
media  of  the  eye,  the  lens  and  the  vitreous  humour.  Himstedt 
and  Nagel  proved  a  stimulative  action  of  ultra-violet  and  Roent- 
gen-rays on  the  frog's  eye. 

F.  Himstedt  reports  that  it  is  surprising  how  quickly  the 
eye  tires  of  this  sensation  of  light.  If  two  perfectly  similar  little 
bags  of  light-proof  paper  are  prepared,  the  one  filled  with 
radium,  the  other  with  a  corresponding  quantity  of  sand,  and  if 
these  are  placed  alternately  on  the  eyes,  it  is  impossible,  after 
about  30  repetitions  of  the  experiment,  for  any  one  to  tell  on 
which  eye  the  radium  and  on  which  the  sand  is  placed. 

Blind  persons  who  have  lost  their  sight  through  opacity  of 
the  cornea  or  of  the  lens,  have,  as  might  be  expected,  a  sensa- 
tion of  light  under  the  action  of  the  Becquerel-rays. 

Grunmach  noticed  phenomena  of  irritation  in  the  retina 
when  working  with  radium.  For  some  hours  after  he  felt  a 
glimmering  sensation  in  his  eye. 

Dr.  Javal~)  together  with  M.  Cnrie  made  several  experi- 
ments on  blind  persons  with  a  very  powerful  radium  salt;  this 
was  enclosed  in  a  glass  tube,  which  again  was  kept  in  an  opaque 
box  of  cardboard.  The  two  blind  persons  first  examined  saw 
nothing;  the  radium  gave  them  no  sensation  of  light.  One  of 
them  had  lost  his  sight  through  atrophy  of  the  visual  nerves, 
the  other  through  glaucoma.  Javal  and  Curie  pursued  their 
investigations  further  in  the  Blind  Institute  in  Paris.  One 
blind  person,  a  boy  who  had  lost  his  sight  through  displacement 
of  the  retina,  had  still  some  slight  capacity  for  receiving  light 
impressions.  Under  the  influence  of  the  rays  from  the  radium 
his  whole  field  of  vision  was  lighted  up,  and  again,  even  when 


*)  Physik.  Zeitschr.,   igoi,  II.  Jahrg.  p.  362. 
^)   Physikal.  Zeitschr.,  1900,  I,  p.  476. 


BECOUEREL.RAYS  3^3 

he  covered  his  eye  with  both  hands,  he  perceived  light.  From 
this  experiment  Dr.  J  aval  draws  the  conclusion  that  if  it  were 
possible  to  restore  the  transparency  of  the  cornea  the  boy  might 
recover  his  sight  to  a  great  extent. 

Little  is  known  as  yet  as  to  other  physiological  action  of 
Becquerel-rays. 

E.  Aschkinass  and  Jf\  Caspari^)  were  unable  even  after 
several  hours'  exposure  to  Roentgen-  and  Becquerel-rays  to  dis- 
cover that  they  had  any  effect  on  the  consumption  of  oxygen 
by  muscle  preparations  made  from  frogs. 

§  37.  H.  Strebel  made  therapeutic  experiments  with  radium 
substances  in  lupus.  According  to  his  reports,-)  reaction  took 
place  in  so  far  that  the  nodules  became  distinctly  paler  and  the 
tissues  softer.  On  another  occasion  he  reports^)  having  pro- 
duced an  ulcer  in  a  lupus  patient. 

Danlos  and  Block  cured  two  cases  of  lupus  erythematosus 
by  the  application  for  24  to  63  hours  of  two  preparations  with 
an  activity  of  5,000  and  5,200  respectively"*).  Further,  Dan- 
los treated^)  four  cases  of  lupus  vulgaris  with  two  radium 
preparations  with  an  activity  of  2,500  and  19,000.  The  period 
of  application  varied  from  24  to  36  hours.  The  treatment 
answered  excellently.  The  scars  were  smooth,  soft  and  super- 
ficial. With  weaker  preparations  too  (activity  of  1,000  to 
1,800)  Danlos  gained,  as  he  reports,  favourable  results  for  the 
time,  but  recurrence  soon  took  place.  Danlos  considers  the 
stronger  preparations  to  be  the  more  suitable  for  therapeutic 
use,  as  the  weaker  ones  have  to  be  applied  for  a  very  long  time 
before  they  produce  any  effect,  and  this  inevitably  causes  ulcera- 
tion. Such  complications  may,  he  believes,  be  avoided  by  using 
the  stronger  preparations,  which  require  less  time. 

According  to  Danlos,  the  course  of  radium  reaction  is  as 
follows:  The  first  redness  shows  itself,  then  after  6  to  20  days 


')  73-  Versammlung  d.  Naturforschcr  u.  Aerzte  in  HamburR,  1901. 
^)  VII  Congress  of  the  German   Dcrmatological   Soc,   Brt-slau,  Transac- 
tions, p.  488. 

')   73-  Versammlung  d.  Naturfi.rsclicr  u.  Acrztc,  Hamburg,  1901. 
*)   Soc.  d.  dcrmatolog.  et  d.  syph.,  Nov.  7U1,  1901. 
")   Ibid.    July  3rd,  1902. 


364  RADIO-THERAPY 

the  epidermis  becomes  whitish,  macerated,  and  peels  off.  Often 
a  bulla  appears,  which  bursts  and  leaves  an  ulcer.  The  ulcer 
discharges  freely,  and  is  deeper  or  more  superficial  and  more 
or  less  painful  according  to  the  intensity  of  the  ray's  action. 
The  pains,  as  in  Roentgen-dermatitis,  are  often  more  pro- 
nounced by  night.  Danlos  recommends  radium  in  lupus  vul- 
garis and  erythematosus,  hypertrichosis,  superficial  malignant 
disease  and  nasvus. 

Hallopeaii  and  Gadaud^)  treated  lupus  verrucosus  of  the 
hand  with  radium.  The  preparation  had  an  activity  of  19,000. 
It  was  applied  from  72  to  120  hours.  After  this  there  was  a 
change  of  colour,  and  in  15  days  an  ulcer  appeared  with  yellow- 
ish base  and  regular  borders;  the  ulcer  was  the  seat  of  shooting 
pains.  At  the  same  time  the  hand  became  very  stiff.  Other 
parts  which  were  only  exposed  for  24  hours  appeared  markedly 
improved. 

Oiidin  proposed  that  in  order  to  allow  only  the  X-rays  from 
radium  preparations  to  act  the  substance  should  be  encased  in 
aluminium,  which  absorbs  cathode-rays  better  than  X-rays.  He 
believes  he  has  proved  by  experiments  on  guinea-pigs  that  vari- 
ous parts  of  the  body  react  differently  to  radium  rays. 

From  the  little  that  we  know  as  yet  of  the  biological  action 
of  the  Becquerel-rays  we  may  assume  that  they  are  in  this  respect 
very  similar  to  the  Roentgen-rays.  Like  the  latter,  they  produce 
on  the  skin — earlier  or  later,  according  to  the  intensity  of  the 
irradiation — a  kind  of  dermatitis,  which  besides  other  peculiari- 
ties (epilation)  is  specially  marked  by  its  slow  course  and  the 
sluggish  character  of  the  lesions  induced.  Their  action,  too,  on 
the  eye  is  analogous  to  that  of  the  Roentgen-rays.  With  regard 
to  the  bactericidal  action  of  the  rays  of  radio-active  substances 
opinions  are  still  divided.  It  would  seem  that  only  one  special 
kind  of  rays  is  effective  (/'.  c,  those  easily  absorbed),  and  that 
only  under  special  conditions  and  when  very  powerful  prepara- 
tions are  used. 

We  require  further  experience  before  we  can  determine  how 
far  these  rays  are  of  practical  therapeutic  value.     For  the  pres- 


^)   Soc.  d.  dermatolog.  et  d.  syph.,  Nov.  7th,  1901. 


BECOUEREL-RAYS  365 

ent  they  possess  only  scientific  interest,  partly  because  of  the 
difficulty  of  making  radio-active  preparations  and  their  enor- 
mous price,  but  partly  also  because  few  preparations  are  actinic 
to  the  same  extent,  and  it  is  hence  impossible  to  give  directions 
for  the  strength  and  duration  of  treatment  which  shall  be  uni- 
versally applicable. 


V. 

TREATMENT    WITH     HEAT    AND     LIGHT 
RAYS.      (PHOTOTHERAPY.) 


TREATMENT  WITH   HEAT  AND  LIGHT 
RAYS.      (PHOTOTHERAPY.) 

I.     Elements  of  Photophysics. 

§38.  Light  is  the  agency  which  renders  bodies  visible. 
There  are  two  hypotheses  concerning  its  nature.  Ncivton  held 
that  luminous  bodies  emit  a  very  fine  matter,  which  produces  in 
the  eye  the  sensation  of  light.  This  hypothesis  is  called  the  emis- 
sion theory.  According  to  the  wave  or  undulation  theory,  formu- 
lated by  Huyghcus  at  the  end  of  the  1 7th  century,  light  consists 
in  an  undulatory  movement  of  ether,  an  exceedingly  elastic,  im- 
ponderable medium  which  pervades  the  whole  universe,  pene- 
trating even  between  the  molecules  of  material  bodies.  Waves 
proceeding  from  the  source  of  light  reach  the  eye  and  irritate 
the  visual  nerves  of  the  retina,  thereby  producing  in  the  brain 
the  sensation  of  light.  This  theory  enables  us  to  explain  readily 
most  optical  phenomena. 

To  Thomas  Young  we  owe  the  fundamental  discovery  that 
the  law  of  interference  is  applicable  to  light  as  well  as  sound. 
He  applied  the  wave-theory  successfully  to  explain  the  colours 


^)  Text-books  and  references:  /.  M.  Edcr,  Ausfiihrl,  Handliuch  der 
Photographic,  Hallc,  1891. — /.  M.  Edcr,  Jahrbiicher  f.  Photograi)hic  und 
Reproductionsverf.  i.  bis.  16  Jahrg.,  Halle  a.  S. —  /-/.  M.  Vogcl,  Handbuch  dcr 
Photographie,  Berlin,  1894.  —  MiUlcr-Pouillct,  Lehrbuch  der  Physik,  Vol. 
II,  I.  —  H.  Kayscr,  Lehrbuch  d.  Physik,  Stuttgart,  1900. — F.  Kbrncr,  Lehr- 
buch d.  Physik,  Vienna,  1897. — E.  Ricckc,  Lchrb.  d.  Experimentalphysik, 
Leipzig,  1896.  —  F.  Frankcnh'duscr,  Das  Licht  als  Kraft,  Berlin,  1902.  —  Niels 
R.  Finscn,  Ueber  die  Anwcndung  von  conccntrirten  Lichtstrahlen  in  der 
Medicin,  Leipzig,  1899.  —  Finscn,  Die  Bcdcutung  der  chcm.  Strahlcn  des 
Lichtes.  Leipzig,  1899.  —  Magnus  Mocllcr,  Dcr  Einfluss  dcs  Lichtes  auf  die 
Haut,  Biblioth.  med.,  Stuttgart,  1900.  —  Gcbhard.  Die  Hcilkraft  des  Lichtes, 
Leipzig,  1898.  —  O.  Lassar,  Ueber  die  neuercn  Methodcn  dcr  Lupusbehand- 
lung,  Zeitschr.  diiitct.  u.  physikal.  Therapie,  1900-01,  Vol.  IV,  H.  i. — 
H.  Strebel,  Die  Vervvcndung  dcs  Lichtes  m  dcr  Therapie,  Munich,  1902. — 
/.  Raum,  Der  gegcnwartig  Stand  unserer  Kentnissc  ueber  den  Einfluss  dcs 
Lichtes  etc..  Zeitschr.  f.  Hygiene,  Vol.  VI.  p.  312  etc.  —  //.  Ricdcr,  Hand- 
buch  d.  physikal.  u.  diiitet.  Therapie,  Part  I,  Vol.  IL 


370  RADIO-THERAPY 

on  certain  kinds  of  thin  plates  and  ridged  surfaces.  All  his 
experiments  in  interference  were  explicable  on  the  assumption 
that  light  is  a  wave-movement;  the  idea  that  light  consists  of 
flying  particles  explained  nothing.  Young  discovered  also  the 
difference  between  light  waves  and  sound  waves,  viz. :  that  in 
sound  waves  the  air  vibrates  in  the  direction  of  propagation 
(longitudinal  air-vibrations),  whereas  in  light  waves  the  ether 
particles  move  vertically  to  the  direction  of  propagation  (trans- 
verse ether-vibrations). 

Just  as  there  are  high  and  low  notes,  so  there  are  varying 
rates  of  ether-vibration.  Violet  light,  for  instance,  makes  nearly 
twice  as  many  vibrations  as  red.  The  waves  of  red  light  are 
therefore  nearly  twice  as  long  as  the  waves  of  violet  light,  for 
in  the  atmospheric  ether  all  are  propagated  with  equal  velocity. 
The  vibrations  of  ether  particles  may  proceed  along  straight 
lines  vertical  to  the  ray  of  light,  and  in  so  doing  may  either  he 
all  on  one  plane  throughout  the  ray — this  is  rectilinear  polarisa- 
tion— or  they  may  move  in  turn  in  all  directions,  as  in  the  case 
of  ordinary  light.  When  the  vibrations  proceed  along  circular 
or  elliptic  courses,  circular  or  elliptic  polarisation  takes  place. 
The  surface  of  a  luminous,  like  that  of  a  resonant,  body  may 
produce  waves  of  varying  size;  hence  daylight  or  composite 
light — like  complexity  of  sound — consists  of  light  of  all  possi- 
ble colours  and  directions  of  polarisation.  The  simplest  light 
is  that  which  shews  only  one  colour,  or  which  consists  of  waves 
of  equal  length  and  is  polarised  in  straight  lines. 

Of  late  a  theory  has  been  brought  forward  which  is  founded 
largely  on  the  work  of  Maxwell  and  Hertz  and  on  our  gradu- 
ally increasing  knowledge  of  the  correlation  of  electricity,  mag- 
netism, and  light.  This  theory  regards  ether-movements  as 
the  common  cause  of  all  three  classes  of  phenomena.  Scientists 
have  inclined  lately  more  and  more  to  the  assumption  that 
luminosity  is  brought  about  not  by  the  movements  of  atoms 
themselves,  but  by  the  movements  with  and  upon  them  of  their 
electrical  charges,  electrons. 

§  39.  Bodies  which  are  in  themselves  sources  of  light,  /.  e., 
which  become  visible  through  their  own  power,  are  called  self- 
luminous  bodies. 


PHOTOTHERAPY  371 

Amongst  terrestrial  bodies  those  which  glow  and  burn  are 
self-luminous. 

As  long  as  they  are  at  a  fairly  low  temperature  (less 
than  400°)    they  send  out  rays  of  great  wave-length 
(heat-rays)  ;  with   increase  of  temperature  the   wave- 
length lessens.    The  heating  power  of  light-rays  lessens 
in  the  spectrum  towards  the  violet  end.     As  the  tem- 
perature becomes  higher,  the  constant  movement  of  the 
molecules  composing  the  bodies  becomes  more  violent. 
The  atoms  of  which  the  molecules  again  consist  begin 
to  vibrate  when  the  latter  collide,  and  the  vibration  is 
communicated  to  the  ether  surrounding  the  atoms.     As 
the  molecular  movement  grows  in  intensity  the  clashing 
of  the  molecules   becomes  more   violent,    and  thereby 
quicker    vibrations    of    the    atoms    and    the    ether    are 
induced. 
Again  there  are  in  nature   (in  the  vegetable,  animal  and 
mineral  kingdoms)  bodies  which  are  self-luminous  in  the  dark. 
Amongst  self-luminous  bodies  we  must  in  the  first 
place  include  the  sun  and  the  fixed  stars;  of  terrestrial 
substances  there  are,  firstly,  those  which  glow  by  reason 
of  their  high  temperature  (hot  or  molten  metals,  glow- 
ing carbon  in  illuminating  gas,  in  electric  lamps,  etc.)  ; 
secondly,   luminous  organisms    {e.  g.,  those  on   rotten 
wood,    fireflies,    the    infusoria    which    produce    marine 
phosphorescence,   certain  jelly-fish,   etc.).     The  source 
of  light  in  the  latter  class  is  as  yet  by  no  means  accounted 
for. 
Non-luminous  bodies  may  be  classified  as  transparent,  trans- 
lucent, and  opaque,  according  as  they  allow  more  or  less  free 
passage  to  the  ether  waves  striking  them,  or  as  they  absorb  them 
entirely.     There  are  no  absolutely  transparent  bodies.     Thick 
layers  of  even  the  most  transparent  bodies  appear  slightly  col- 
oured, a  sign  that  part  of  the  white  light  falling  on  them  has 
been  absorbed.     The  space  through  which  light  passes  is  called 
(whether  it  contain  solid  matter  or  not)   the  mcd'uim.    A  very 
small  luminous  body  or  a  very  small  luminous  surface  is  called 
a  "point"  of  light. 


372  RADIO-THERAPY 

§  40.  A  straight  line  along  which  light  is  propogated  is 
called  a  ray  of  light.  Objects  may  be  discerned  through  straight 
tubes,  not  through  curv^ed  ones. 

Liglit  is  propagated  in  straiglit  lines  in  all  directions. 

The  extension  of  light  in  straight  lines  may  be  observed 
where  sun  rays  fall  into  a  dusty  room.  The  formation  of 
shadows,  too,  is  only  explicable  on  the  hypothesis  of  the  recti- 
linear extension  of  light. 

I.  The  term  "light  ray"  must  be  conceived  of  as  a 
purely  geometric  definition,  as  the  straight  connecting 
line  which  we  imagine  as  drawn  from  a  point  of  light 
to  some  illuminated  point.  A  light  ray  has  no  physical 
existence  at  all.  A  number  of  light  rays  are  called  a 
bundle  of  rays. 

The  phenomenon  of  the  reception  of  light  by  one  point  from 
another  luminous  point  in  the  same  medium,  in  spite  of  the 
breaking  of  the  straight  connecting  line  between  the  two  points 
by  an  opaque  body,  is  called  "deflection  of  light."  The  velocity 
of  propagation  of  light  was  first  estimated  by  astronomical 
means.     It  may  be  taken  as  being  299,300  kilom.  a  second. 

§  41.  If  light  is  thrown  on  a  sheet  of  paper  from,  say,  a 
candle  flame,  the  paper  is  illuminated  less  brightly  in  proportion 
as  it  is  removed  further  from  the  source  of  light;  or,  the  dis- 
tance from  the  source  of  light  remaining  the  same,  as  the  angle 
of  inclination  at  which  the  light  rays  strike  the  paper  becomes 
less. 

Light  rays  being  projected  along  straight  lines,  it  follows 
that  the  light  effect  spreads  over  spherical  surfaces,  of  con- 
stantly increasing  diameter,  the  superficial  area  being  propor- 
tional to  the  squares  of  the  diameters;  hence  the  intensity  of 
illumination  of  a  given  surface  by  rays  striking  it  perpendicularly 
diminishes  in  proportion  to  the  square  of  its  increasing  distance 
from  the  source  of  light. 

The  strength  of  light  varies  inversely  as  the  square  of  the 
distance. 

If  the  distance  be  doubled,  the  strength  of  the  light  is  dimin- 
ished to  one-fourth;  if  the  distance  be  increased  threefold,  the 
strength  of  light  is  one-ninth,  and  so  on.     Thus,  if  the  distance 


PHOTOTHERAPY  373 

be  multiplied  by  four,  the  strength  of  the  source  of  light  must 
be  multiplied  by  sixteen  in  order  to  gain  an  equally  powerful 
illumination. 

A  surface  is  illuminated  most  powerfully  when  the  effective 
light  rays  strike  it  at  right  angles.  If  the  illumination  is  oblique, 
fewer  rays  fall  on  the  same  plane;  some  of  the  rays,  too,  are 
longer,  and  hence  feebler  in  light  as  they  strike  the  plane. 

Whilst  therefore  the  brightness  of  a  self-luminous  body 
depends  on  the  intensity  of  the  light  in  each  single  point  and 
on  the  size  of  the  illuminating  plane,  the  brightness  of  illumi- 
nated bodies  depends  further  on  their  distance  from  the  source 
of  light  and  on  their  position  in  relation  to  it. 

The  strength  of  illumiualion  of  a  plane  surface  by  parallel 
light  rays  is  proportional  to  the  cosine  of  the  angle  of  incidence 
of  the  rays. 

The  brightness  of  a  body,  i.  e.,  the  amount  of  light  which 
it  reflects,  is  further  dependent  on  its  colour  and  its  albedo. 

The  albedo  of  a  body  is  that  numerical  value  which  gives 
the  proportion  of  white  light  falling  on  a  body  compared  with 
that  which  is  reflected  from  it. 

§  42.  It  is  not  possible,  by  the  eye  alone,  to  estimate  with  even 
approximate  accuracy  the  relative  brightness  of  two  illuminating 
planes,  or  of  the  various  points  {e.  g.,  in  a  gas  flame)  where  the 
intensity  varies.  The  aid  of  photometers  has  therefore  to  be 
called  in;  these  make  it  possible  to  estimate  with  certainty  the 
relative  intensity  of  two  illuminating  bodies. 

The  strength  of  light  is  denoted  in  normal  candle-power. 
In  Austria  and  Germany  the  normal  parafl'in  candle  {N  K) 
(20  millimetres  in  diameter  and  with  a  flame  50  millimetres  in 
height)  was  formerly  often  used  in  denoting  the  intensity  of 
a  light  source.  It  is  generally  known  as  the  German  unit.  In 
the  last  few  years  the  more  exact  Hefner-Alteneck  normal  lamp, 
burning  amyl-acetatc,  has  been  more  and  more  used  as  the 
light-unit. 

In  England  the  light  unit  is  a  certain  sperm  candle  (stand- 
ard candle),  in  France  a  certain  oil  lamp  (bee  carcel).  The 
unit  of  measurement  for  the  illuminating  power  of  an  illumi- 
nated plane  is  the  metre  candle  (  i  M.  K.),  i.  e.,  the  illuminating 


374  RADIO-THERAPY 

power  produced  by  i  normal  candle  at  a  distance  of  i  metre, 
where  the  light  rays  strike  perpendicularly.  Photometers  serve 
to  measure  the  optical  intensity  of  a  source  of  light,  /.  e.,  to  com- 
pare its  strength  with  that  of  a  normal  candle. 

In  Riiinford's  shadow-photometer  two  shadows  of 
an  opaque  stick  are  cast  on  a  white  plane,  the  one  by 
the  source  of  light  to  be  measured  (L),  the  other  by 
the  normal  candle  (/)  ;  one  source  of  light  remaining 
at  the  same  distance  (d),  the  other  is  moved  on 
(up  to  D)  until  the  two  shadows  appear  equally  dark. 
Then  L  :l  =  D—.d\ 


L         '^^ 


=   (f 


In  L.  JFeher's  photometer  light  is  thrown  on  2  opa- 
lescent glasses,  on  one  from  a  constant  flame,  on  the 
other  from  first  one  and  then  the  other  source  of  light. 
A  completely  reflecting  prism  brings  the  images  of  the 
glasses  side  by  side.  By  regulating  the  distances  equality 
of  brightness  is  produced. 

The  principle  of  Bunsen's  grease  spot  photometer 
Is  that  a  grease  spot  on  a  piece  of  white  paper  appears 
dark  when  light  is  thrown  on  it  from  a  source  of  light 
in  front,  and  light  when  it  is  lighted  up  from  behind. 
If  light  is  thrown  on  the  paper  from  the  back  and  the 
front  at  once,  the  grease  spot  will  look  alternately  dark 
and  light,  according  as  the  back  or  the  front  light  is  the 
stronger.  If  the  one  light  is  kept  stationery  and  the 
other  brought  nearer  or  further,  a  point  will  soon  be 
found  at  which  the  grease  spot  will  vanish,  i.  e.,  become 
invisible,  because  it  will  then  look  as  bright  as  the 
surrounding  paper. 

Here,  as  in  the  case  of  the  Riimford  photometer, 

the  equation  holds  good :    L:  I  =:  D' :  d". 

These  photometers  can  only  determine  the  intensity  of  the 

effect  of  the  light  on  our  eye.     But  this  is  essentially  different 

from  the  intensity  of  the  chemical  effect  of  the  light.     No  direct 


PHOTOTIIERJPY  375 

conclusion  can  therefore  be  drawn  with  regard  to  the  chemical 
effect  of  various  sources  of  light  from  their  brightness  as 
determined  by  the  photometer.  For  testing  the  chemical  inten- 
sity of  a  source  of  light  recourse  is  had  to  photographic  photo- 
meters or  actbiometcrs  (/.  e.,  scns'ilovicters),  which  are  based 
on  the  chemical  action  of  light  on  substances  sensitive  to  its 
effect.  Sensitiveness  of  various  substances  {e.  g.,  silver  salts) 
to  the  chemically  effective  rays  varies  according  to  their  colour 
sensitiveness. 

The  photometer  of  Biinscu  and  Roscoe  is  based  on 
the  fact  that  chlorine  and  hydrogen  combine  to  form 
hydrochloric  acid,  slowly  in  diffused  and  explosively  in 
direct  sunlight.  The  amount  of  hydrochloric  acid  which 
is  formed  In  a  given  time  and  dissolves  In  the  water 
serves  as  a  measure  of  comparison  for  the  ^•arious 
sources  of  light. 

The  Eder  photometer  Is  based  on  the  decomposition 
of  a  mixture  of  bl-chloride  of  mercury  with  neutral 
ammonium  oxalate.  The  Intensity  of  the  effective  light 
is  estimated  according  to  the  amount  of  sub-chloride  of 
mercury  precipitated.  Eder  proved  experimentally  that 
about  90%  of  the  precipitate  of  chloride  of  mercury  was 
the  work,  of  the  ultra-violet  rays,  only  10%  being  pre- 
cipitated by  the  rest  of  the  spectrum. 

Further,  there  are  actlnometers  made  from  sensi- 
tised papers.  These  are  constructed  on  one  or  other  of 
two  principles.  Either  exposure  is  made  until  the  paper 
assumes  a  certain  normal  colour  (photometers  on  Bidi- 
sen's  and  Roscoe' s  principle),  or  exposure  is  made  with 
a  scale  of  regularly  diminishing  strength  of  light  (as, 
e.  g.,  with  superimposed  strips  of  transparent  paper), 
and  observations  arc  taken  of  the  progress  of  the  photo- 
graphic effect  ') . 

A.  Earsen  with  his  chloride  of  silver  paper  photo- 
meter measures  the  blackening  of  the  paper  as  the  light 
passes  through. 


')  J.  M.  lidcr,  Ausfiihri.   I  landlnu-h  <1.   I'lK-logr..   I,   i.  p.  .352. 


376  RADIO-THERAPY 

While  photometry  by  means  of  the  ordinary  photo- 
graphic papers  is  used  to  measure  the  intensity  of  the 
blue-violet  and  ultra-violet  rays  alone,  it  is  possible,  by 
adding  certain  colouring  matter  to  the  bromide  of  silver, 
to  render  the  normal  papers  sensitive  to  other  classes  of 
rays.  This  was  shown  by  Andresen  with  rhodamin 
paper,  which  is  sensitive  to  yellow  light;  the  bromide 
of  silver  indeed  still  remains  very  sensitive  to  blue- 
violet,  but  this  is  counteracted  by  the  use  of  yellow 
filters  {aiiramin) . 

A.  JFingen's  is  a  normal  colour  photometer  con- 
structed on  the  same  principle.  /.  M.  Eder  proved  the 
colour-sensitiveness  of  Aridreseii's  rhodamin-bromide  of 
silver  paper,  and  of  rhodamin-chloride  of  silver  and 
other  papers  by  a  series  of  experiments,  from  which  it 
appeared  that  such  photometer  papers  are  affected  by 
different  zones,  of  the  spectrum,  according  as  they  are 
exposed  to  a  more  or  less  strong  light.  When  shutting 
out  (by  yellow  light  filters)  the  blue  and  violet  rays, 
which  become  effective  with  longer  exposures,  it  is  neces- 
sary to  take  into  account  the  concentration  and  quality 
of  the  filtering  colour^). 

Electric  photometers  are  based  either  on  a  peculiar 
property  of  selenium,  which  is  a  better  conductor  of 
electricity  in  the  light  than  in  the  dark,  or  on  the  elec- 
tric currents  resulting  from  the  chemical  action  of  light 
on  chloride  of  silver  plates. 

A.  Larseti  constructed  an  actinoscope  for  ultra-violet 
rays,  based  on  the  fact  that  ultra-violet  rays  are  favour- 
able to  the  formation  of  electric  sparks.     The  spark  of 
a  Riihmkorff  coil  jumps  across  a  longer  spark-gap  if  the 
negative  electrode  be  irradiated  by  ultra-violet  rays. 
The  mechanical  effects  of  light  and  its  power  of  producing 
phosphorescence  have  been  utilised  in  the  construction  of  photo- 
metric apparatus    (radiometers,   Warnecke's  phosphorescence- 
photometer),  but  such  apparatus  have  been  but  little  used  in 
practice. 

')   Wiener  klin.   Wochenschr.,    1902,   No.   29. 


PHOTOTHERAPY  377 

§  43.  The  theory  of  the  refiection  of  Hght  is  called 
katoptrics. 

If  a  light  ray  falls  on  an  opaque  body  the  light  is  thereby  pre- 
vented from  passing  along  a  straight  line  in  the  same  direction. 

In  such  a  case  part  of  the  light  is  thrown  back  or  reflected. 
If  the  reflecting  surface  is  smooth  the  resulting  effect  on  the 
light  is  termed  reflccTwn;  if  the  surface  is  more  or  less  rough 
dispersion  or  diffusion  results. 

Mirrors  may  he  plane,  or  they  may  have  curved  surfaces. 
If  the  curve  is  outwards  the  mirror  is  co?ivex;  if  the  mirror  is 
like  part  of  a  sphere,  polished  on  the  inside,  it  is  conca-ct'.  The 
angle  at  which  a  light  ray  falls  on  a  mirror  is  called  the  an^le 
of  incidence;  the  angle  at  which  the  ray  is  reflected  from  the 
mirror  is  called  the  cuigle  of  reflection. 

The  angle  of  reflection  of  light  is  equal  to  the  angle  of 
incidence. 

Light  rays  falling  on  a  concave  mirror,  spherically  curved, 
so  as  to  pass  through  the  centre  of  the  sphere  of  which  the  mir- 
ror forms  a  part,  are  called  axis  rays.  The  spherical  centre 
of  the  mirror  surface  is  called  the  centre  of  curvature,  and  the 
straight  line  passing  through  this  point  and  the  curve-centre  of 
the  mirror  itself  is  the  optical  axis  of  the  mirror. 

An  axis  ray  is  reflected  directly  back. 

Rays  parallel  to  the  axis  of  the  concave  mirror  {e.  ^^.,  the 
sun  rays,  coming  from  an  infinite  distance)  are  reflected  in  such 
a  manner  that  all  pass  throntrh  the  burning-point  or  focus. 
The  focus  is  therefore  the  gatliering-paint  of  all  the  rays  that 
strike  the  mirror  parallel  zvith  the  axis. 

The  focus  of  a  concave  mirror  lies  on  the  main  axis,  niidzvay 
betzveen  the  mirror  centre  and  tlie  sphere  centre. 

As  the  source  of  light  approaches  the  mirror,  so  that  its 
rays  are  no  longer  parallel  to  each  other,  the  focus  recedes 
further  and  further,  even  to  infinity,  when  the  source  of  light 
is  in  the  focus.  The  reflected  rays  are  then  parallel.  They 
become  divergent  when  the  source  of  light  is  brought  between 
the  focus  and  the  surface  of  the  mirror. 

Important  practical  use  has  been  made  of  this  power 
of  li<rht  dispersion    for  li'dit-Droicctors.    Mangiti  in  his 


378  RADIO-THERAPY 

apparatus  uses  spherical  concave  mirrors,  consisting  of 

weak    concavo-convex    lenses    with    a    silver    coating. 

Schuckcrt's  glass  parabolic  mirrors,  being  in  one  piece, 

have  the  advantage  over  Mangins  of  being  free  from 

chromatic  and  spherical  aberrations    (see  52),  and  of 

absorbing  little  light;  further,  they  allow  of  the  choice 

of  a  suitable  focal  distance.    An  arc-light  is  used.    The 

carbons   lie   horizontally;   the   crater- formation  on  the 

positive  carbon  thus  produced  enables  the  source  of  light 

to  be  more   fully  utilised  at  a  medium   focal  distance 

from  the  mirror. 

The  laws  governing  the  origin  of  the  various  Images  cast 

by  mirrors  will  not  be  treated  of  here,  as  they  have  no  bearing 

on  our  present  subject. 

§  44.   The  theory  of  light  refraction  is  termed  dioptrics. 
We  have  seen  above  that  opaque  bodies  do  not  allow  of  the 
rectilinear  extension  of  light,  but  reflect  It.     The  direction  of 
light  rays  Is  altered  further  by  transparent  bodies,  i.  e.,  by  those 
which  allow  a  large  part  of  the  light  to  pass  through. 

An  oblique  ray,  passing  from  one  transparent  body  into 
another  which  transmits  light  at  a  different  rate  changes  its 
direction,  i.  e.,  is  refracted. 

Refraction  is  governed  by  the  following  laws: 

1.  The  Incident  and  the  refracted  rays  are  on  opposite  sides 
of  the  axis  of  Incidence  and  lie  In  one  plane — the  plane  of  inci- 
dence. 

2.  l^he  quotient  of  the  sine  of  the  angle  of  incidence  and 
the  sine  of  the  angle  of  refraction  equals  the  ratio  of  the  velocity 
of  light  in  the  two  media,  and  Is  called  the  quotient  of  refrac- 
tion, or  "refraction"  index. 

Rays  impinging  at  right  angles  on  the  dividing  surface  of 
two  transparent  bodies  are  not  refracted. 

The  refraction  index  depends  on  the  rate  of  vibration  of 
the  light  ray,  /.  e.,  Its  colours. 

The  refraction  of  light  by  means  of  polished  glasses  is  fre- 
quently turned  to  practical  account.  Glasses  with  polished 
spherical  convex  surfaces  are  called  lenses, ov  convex  lenses;  they 
are  thicker  In  the  middle  than  at  the  edges.     Glasses  which  are 


PHOTOTHERAPY  379 

hollowed  out  or  concave  (hence  thicker  at  the  edges  than  at  the 
centre)  are  called  hollow  or  concave  lenses. 

The  optical  axis  of  a  lens  is  the  straight  line  passing  through 
the  curve  centre  of  its  two  surfaces,  or — if  one  surface  be  plane 
— through  the  one  curve  centre,  falling  perpendicularly  on  the 
plane  surface.  Rays  striking  a  concave  lens  parallel  with  the 
axis  are  dispersed  after  refraction.  The  axial  rays  passing 
through  the  centre  of  the  lens  are  not  refracted. 

Objects  looked  at  through  a  concave  lens  appear  smaller  and 
nearer. 

Sun  rays  passing  through  a  lens  convex  on  both  sides  are 
so  refracted  as  to  converge  as  one  point  of  light  at  a  certain  dis- 
tance from  the  lens.  A  piece  of  paper  held  at  this  converging 
point,  the  focus,  becomes  heated  and  finally  burns.  The  convex 
lens  acts  as  a  burning  glass. 

Light  rays  impinging  on  a  convex  lens  parallel  with  the  axis 
are  so  refracted  as  all  to  pass  through  the  focus. 

The  distance  of  the  focus  from  the  centre  of  the  lens  is 
called  the  focal  distance. 

Rays  passing  through  the  focus  and  impinging  on  a  convex 
lens  are,  after  refraction,  parallel  with  the  axis  of  the  lens. 
The  axial  rays  pass  through  without  refraction. 

All  objects  within  the  focal  distance  appear,  when  seen 
through  a  convex  lens,  larger  and  more  distant.  The  image  of 
an  object  outside  the  focal  distance  appears  reversed. 

The  effect  of  a  lens  depends  on  its  diameter  and  its  curv^e,  as 
well  as  on  the  refracting  power  of  its  substance. 

§  45.  Parallel  rays  striking  a  large  spherical  concave  mirror, 
or  a  spherical  lens  close  to  the  edge,  do  not  converge  in  one  focus 
after  reflection,  but  spread  over  a  wider  zone,  whose  axis  is 
the  focal  line  proper.  The  effect  of  this  spherical  aberration 
is  to  blur  the  image.  It  happens  especially  with  thick  lenses, 
and  is  due  to  the  disturbing  influence  of  the  prisms  of  which 
one  may  imagine  a  lens  composed.  Lenses  are  further  subject 
to  chromatic  aberration.  They  break  up  white  light  into  its 
component  parts,  as  docs  a  prism.  Hence  if  a  bundle  of  rays 
is  thrown  on  a  convex  lens  parallel  to  the  optical  axis,  the  violet 
rays,  being  refracted  at  a  sharper  angle,  intersect  each  other 


38o  RADIO-THERAPY 

again  behind  the  lens  at  a  shorter  distance  from  it  than  the 
other  rays;  the  red  rays  intersect  at  the  greatest  distance.  At 
whatever  point  the  image  is  caught,  only  one  colour  is  sharp; 
the  others  are  all  blurred. 

Parabolic  mirrors,  on  account  of  the  geometrical  properties 
of  the  parabola,  have  no  focal  plane,  but  only  one  single  con- 
verging point  for  all  parallel  rays.  Hence  parabolic  mirrors 
are  used  in  preference  to  concave  as  light  projectors. 

§  46.  In  most  cases  we  have  to  deal  with  both  reflection  and 
refraction  of  light;  that  is  to  say,  the  whole  of  the  impinging 
light  is  not  reflected,  but  part  of  it  finds  its  way  into  the  second 
medium.  In  other  words,  reflection  is  associated  with  loss  of 
light.  The  amount  of  loss  depends  on  the  nature  of  the  media 
and  the  direction  of  the  rays. 

Part  of  the  refracted  light,  again,  does  not  pass  through 
the  second  medium,  but  is  used  up  in  it,  being  converted  into 
other  forms  of  energy  (heat,  chemical  energy,  etc.). 

Photometric  measurements  prove  that  the  sum  of  the 
strength  of  the  light  reflected  by  a  body  and  that  of  the  light 
passing  through  it  is  less  than  that  of  the  impinging  light  rays. 

This  phenomenon  is  termed  light  absorption.  An  absolutely 
transparent  (diaphanous)  body  would  absorb  no  light  at  all, 
but  such  a  body  is  as  non-existent  as  an  absolutely  opaque 
(adiaphanous)  one,  which  would  reflect  all  the  light  (total 
reflection  excluded). 

Even  gold  and  other  metals  are  transparent  if  sufficiently 
thin.  A  whole  class  of  bodies  {e.  g.,  coloured  glasses)  absorbs 
only  certain  light  colours;  another  (fluorescent  bodies)  changes 
the  colour  of  the  impinging  light. 

Transparent  bodies  become  translucent  by  the  incorpora- 
tion of  foreign  particles,  from  which  the  light  is  diffusely 
reflected.  Opalescent  glass,  blood,  mill<:,  etc.,  are  examples  of 
such  media. 

According  to  the  law  of  the  conservation  of  energy,  the  force 
of  absorbed  light  is  not  lost,  but  is  converted  into  other  forms 
of  energy  of  equal  value.  A  change  takes  place  in  the  condi- 
tion of  the  light-absorbing  substance,  and,  on  the  other  hand, 
those  rays  which  are  absorbed  are  the  only  effective  ones.   Hence 


PHOTOTHERAPY  381 

light  which  has  passed  through  a  substance  and  left  behind  in  it 
some  of  its  component  parts  is  sensibly  weakened. 

§  47.  A  light  ray  passing  through  a  prism  is  diverted  from 
its  original  direction  and  resolved  into  its  component  colours. 
A  colour  series  {spectrum)  appears  of  red,  orange,  yellow, 
green,  blue,  violet;  the  red  appearing  least,  and  the  violet  most 
divergent.  The  yellow  and  orange  of  the  sun  spectrum  are 
about  twice  as  bright  as  the  green,  30  times  as  bright  as  the 
blue  and  the  red,  and  nearly  200  times  as  bright  as  the  violet. 
The  colours  in  the  spectrum  are  neither  of  equal  size  nor  sharply 
defined;  they  merge  insensibly  one  Into  the  other. 

White  light  then  is  composite.  Dispersion  is  the  resolving 
of  a  composite  light  into  its  component  coloured  parts;  each  of 
these,  in  the  case  of  white  light,  is  simple  or  homogeneous.  By 
means  of  a  lens  the  colours  of  the  spectrum  may  be  reunited 
into  white  light. 

Colours  of  bodies  are  not  identical  with  the  colours  of  the 
spectrum,  being  dependent  on  the  light  striking  them.  A  body 
absorbs  certain  coloured  components  of  the  light  and  reflects  or 
permits  the  passage  of  the  rest.  It  is  in  the  one  case  opaquely, 
in  the  other,  transparently,  coloured.  The  colours  of  bodies 
have  thus  no  actual  existence,  but  are  mere  products  of  light. 

A  transparent  body  is  transparently  colourless  if  it  allows 
all  the  parts  of  the  impinging  light  to  pass  through  equally; 
it  is,  e.  g.,  transparently  blue  if  it  absorbs  all  but  the  blue 
rays. 

In  a  blue  solution  of  copper  sulphate  the  red  and  yellow 
rays  chiefly  are  absorbed ;  the  green  and  violet  ones  are  allowed 
to  pass,  but  less  freely  than  the  blue;  hence  the  blue  colour. 

Yellow  colouring  solutions  allow  of  the  free  passage  of  the 
yellow  rays,  and  less  freely  the  red  and  the  green;  they  absorb 
the  blue  and  violet  entirely. 

An  opaque  body  is  white  when  it  reflects  strongly  and  equally 
all  the  component  parts  of  white  light,  and  black  when  it  absorbs 
them. 

It  is  interesting  to  note  that  colourless  bodies  which 
are  equally  transparent  to  light  rays  may  vary  very 
much  in  the  degree  in  which  they  suffer  the  so-called 


382  RADIO-THERAPY 

chemical  rays  to  pass.  For  instance,  "double-spath- 
soda"  absorbs  chemical  rays  less  than  crown  glass  and 
flint  glass;  rock-crystal  and  rock-salt  absorb  them  least 
of  all. 

Red  light  penetrates  bodies  far  .more  readily  than 
blue.  If  lamp-light,  which  has  been  passed  through  a 
thick  sheet  of  paper,  is  subjected  to  spectrum  analysis, 
it  will  be  found  that  nearly  all  the  blue  light  has  been 
absorbed  and  that  only  the  red  and  yellow  remain.  With 
a  thicker  absorbing  layer,  red  alone  passes  through.  The 
same  holds  good  of  gases  and  vapours,  e.  g.,  the  atmos- 
phere (as  may  be  seen  from  the  red  colour  of  stars,  and 
especially  also  of  the  sun,  as  they  near  the  horizon). 

The  sharper  the  angle  at  which  the  light  is  refracted, 
the  more  readily  will  it  be  absorbed. 
According  to  the  wave  theory  of  light,  each  of  the  colours 
making  up  sunlight  has  its  own  rate  of  vibration.  Red  has  the 
lowest  rate  (about  400  billion  vibrations  per  second)  ;  the  vibra- 
tion rate  increases  with  the  other  colours  of  the  spectrum  accord- 
ingly as  they  approach  the  violet  end,  while  violet  itself  has 
the  highest  rate  of  vibration  (about  800  billions  per  second). 

A  ray  of  white  sunlight  thus  comprises  vibrations  ranging 
from  400  to  800  billions  per  second. 

The  various  light-waves  of  a  composite  light  ray  are  dif- 
fracted variously  in  a  prism.  The  red  light,  having  the  lowest 
rate  of  vibration,  Is  least  diffracted,  or  retarded;  the  violet, 
having  the  highest  rate  of  vibration,  suffers  most  diffraction  and 
retardation.  Hence  the  varying  refractive  Indices  of  the  differ- 
ent rays  of  the  spectrum. 

The  cause  of  this  retardation  of  the  smaller  light-waves  was 
for  a  long  time  not  understood,  and  that  It  could  not  explain 
this  phenomenon  was  felt  to  be  a  flaw  In  the  wave  theory. 

Caiichy  lent  fresh  support  to  the  theory  by  establishing  the 
connection  between 'the  velocity  and  the  length  of  a  wave,  when- 
ever the  molecules  of  a  body  are  In  such  a  position  that  the  dis- 
tance between  them  bears  a  distinct  relation  to  the  wave-length. 
Different  colours  have  different  wave-lengths,  decreasing  In  the 
spectrum  from  red  to  violet. 


PHOTOTHERAPY  383 

Hence  the  colour  rays  towards  the  violet  end  of  the  spec- 
trum are  known  as  rays  of  lesser  wave-length,  or  more  highly 
refrangible  rays;  those  towards  the  red  end  as  rays  of  longer 
wave-length,  or  less  highly  refrangible  rays. 

Various  methods,  which  we  will  not  enter  upon  here,  have 
been  used  to  gauge  the  wave-length  of  the  different  kinds  of 
light.  Fraiinhofer  first  determined  the  length  of  the  visible 
rays,  Coruu,  Essclbach,  and  Eisenlohr  that  of  the  ultra-violet, 
Abney^  that  of  the  ultra-red  spectrum. 

To  Angstroem  we  owe  the  more  accurate  measurements, 
and  his  unit  {A  E)  is  now  used  to  denote  wave-lengths: 


AE  = 


mm. 


10,000,000 

Light  of  shorter  wave-length  has  a  correspondingly  shorter 
duration  of  vibration,  but  a  higher  rate. 

The  density  of  the  ether  particles  amongst  the  molecules  is 
greater  in  solid  and  fluid  bodies  than  in  gases;  hence,  light  of 
shorter  wave-length,  on  passing  from  the  air,  is  more  slowly 
propagated  in  solids  and  fluids  than  light  of  greater  wave- 
length.    Hence,  too.  It  is  more  highly  refracted. 

The  solar  spectrum  has  at  either  end  of  Its  apparent  limits 
further  rays;  beyond  the  red,  the  so-called  infra-red  or  ultra-red 
rays  of  greater  wave-lengths  and  lesser  rates  of  vibration  (less 
than  400  billions)  ;  and  beyond  the  violet,  the  so-called  ultra- 
violet, of  shorter  wave-length  and  higher  (more  than  800  bil- 
lions) rates  of  vibration. 

The  principle  that  a  light  ray  is  refracted  more  highly  In 
proportion  to  the  shortness  of  its  wave-length  applies  also  to  the 
invisible  ultra-red  and  ultra-violet  rays. 

Spectroscopes  are  used  for  the  closer  examination  of  the 
spectrum. 

The  white  light  emitted  by  glowing  solid  and  fluid  bodies 
gives  an  unbroken  spectrum. 

If,  however,  sodium  chloride  Is  vaporized  in  the  flame  of  a 
Bunsen  burner,  only  two  bright  yellow  lines  appear  as  the  spec- 
trum of  the  sodium  vapour. 

Lithium  vapour  gives  a  red  and  yellow  line,  as  do  also  salts 
of  barium,  calcium  and  strontium,   livery  metal  when  vapori/.ed 


384  RADIO-THERAPY 

shows  its  own  special  line  in  the  spectrum;  hence  the  presence 
of  certain  lines  in  the  spectrum  of  a  flame  points  conclusively 
to  the  presence  of  the  corresponding  body  in  the  flame.  (Spec- 
trum Analysis.)  Gases,  too,  give  such  spectra  when  examined 
in  Geissler  tubes  and  illuminated  by  an  electric  current. 

If  the  light  of  a  bright  flame  be  passed  through  sodium 
vapour,  the  spectrum  will  show  two  darlc  lines  at  the  spot  where 
sodium  vapour  alone  would  give  two  bright  yellow  ones.  Fol- 
lowing Kirchhof,  we  call  this  phenomenon  "reversal  of  the 
spectrum."  If  the  light  be  passed  through  a  coloured  glass 
plate,  or  a  glass  vessel  filled  with  a  coloured  solution,  the  lines 
of  the  colours  which  have  been  absorbed  on  the  passage  of  the 
light  through  the  coloured  body  vanish  from  the  spectrum,  and 
parts  of  the  spectrum  appear  dark;  thus  we  have  an  absorption 
spectrum. 

This  filtering  or  decomposing  of  white  light  has  long 
been  turned  to  practical  account  in  various  graphic 
crafts. 

In  a  self-luminous  body,  emitting  only  light  of  one  colour, 
i.  e.,  of  one  wave-length,  the  particles  all  vibrate  at  the  same 
rate.  Vibrations  of  the  same  length  strilcing  the  body  set  the 
particles  In  motion^,  like  a  body  resounding  In  unison  with 
another  body  giving  out  the  same  tone.  The  energy  which 
makes  the  particles  vibrate  lessens  the  energy  of  the  i?npinging 
ether  vibrations,  and  weakens  the  light  as  it  passes  through;  but 
the  vibrating  body  at  tlie  same  time  gains  in  energy.  This 
energy,  however,  is  now  radiated  in  all  directions,  not  only  in 
that  of  the  impinging  vibrations,  where  it  is  less  than  before. 

This  is  the  explanation  of  Kirchhoff's  law:  that  a  body, 
which,  when  glowing,  emits  only  light  of  a  given  wave-length, 
absorbs  an  impinging  light  ray  of  the  same  zvave-length.  If 
it  emits  light  of  varying  wave-length,  it  for  the  same  reason 
absorbs  all  corresponding  light  rays.  The  ratio  between  the 
emissive  and  the  absorptive  powers  for  rays  of  a  like  zvave- 
length  is,  as  Kirchhoff  has  proved,  the  same  for  all  bodies  at 
the  same  temperature.    (Eisenlohr.) 

What  becomes  of  the  light  that  has  been  absorbed? 

I.  Absorbed  light  is  usually  transformed  into  heat.     The 


PHOTOTHERAPY  385 

impinging  visible  rays  are  then  emitted  by  the  heated  body  as 
dark  heat  rays  of  greater  wave-length.  Conversely  a  body 
played  on  by  dark  heat  rays  may  be  heated  till  it  shines. 
{TyndaJl  terms  this  calorescence.) 

2.  Absorbed  light  often  causes  the  immediate  emission  of 
new  light  rays  of  a  different  colour  (this  is  /hioreseenee) .  In 
such  cases  the  bodies  are,  as  it  were,  self-luminous  throughout 
the  period  of  their  illumination;  the  colour  of  the  light  they  emit 
is  different  both  from  that  of  the  impinging  light  and  from  that 
peculiar  to  the  body  itself.  The  colours  of  bodies  are  caused 
by  reflected  rays,  fluorescent  colours  by  absorbed  rays. 

3.  Absorbed  light  may  also  cause  a  more  or  less  continuous 
emission  of  new  light  rays  of  different  colours.  This  phenome- 
non, known  as  phosphorescence^  is  seen  in  sulphide  of  calcium, 
sulphide  of  strontium,  etc  ^). 

4.  The  light  may  produce  chemical  effects,  notably  de- 
composition.     Photography    is    based    on    such    effects. 

5.  Electric  phenomena  may  in  many  cases  be  caused  by  the 
impinging  ether  vibrations. 

6.  The  light  may,  under  certain  conditions,  produce 
mechanical    results.      (Crookes'  radiometer.) 

Emission  spectra  may  be  unbroken,  in  lines,  or  in  bands; 
absorption  spectra  show  only  lines  or  bands.     One  end  only  of 


')  Bccquercl  proved  with  the  aid  of  the  phosphoroscope  that  all  solid 
fluorescent  bodies  are  also  phosphorescent,  if  only  for  a  very  short  time. 
Hence  he  concluded  that  fluorescence  and  phosphorescence  are  in  their  essence 
the  rame,  the  difference  lying  merely  in  their  duration. 

Fluorescence  is  chiefly  caused  by  light  of  short  wave-length  ;  the  waves 
in  fluorescent  light  may  be  longer,  but  are  never  shorter,  than  those  in  tlie 
exciting  light. 

Luminescence,  according  to  E.  Wiedemann,  is  luminosity  produced  by 
external  causes  without  any  corresponding  rise  of  temperature.  He  distin- 
guishes several  kinds,  according  to  the  exciting  cause: 

Name.  Exciting  Cause. 

Photo  luminescence  Irradiation 

Electro  "  Electric  di-charge 

Chemico  "  Chemical  processes 

Thermo  "  Sl'K'it  healing 

Tribo  "  Friction 

Crystal  "  Crystallization 


386 


RADIO-THERAPY 


the  spectrum  may  be  absorbed  {e.  g.,  alum  absorbs  ultra-red, 
glass  ultra-violet),  or  both. 

Fraunhofer  observed  innumerable  fine  black  lines  (known 
after  him  as  "Fraunhofer  lines")  in  the  solar  spectrum;  some  of 
the  most  important  of  these  are  shown  in  Fig.  88.  They  were 
named  by  him  after  the  letters  of  the  alphabet. 

Kirchhoff  explained  their  appearance  by  assuming  that  there 
are  certain  gases  present  in  the  gaseous  envelope  of  the  sun 
which  would,  if  not  interfered  with,  produce  bright  lines  where 
dark  pnes  are  shown  in  the  spectrum;  that  is  to  say,  that  the 
light  irradiated  from  the  white-hot  sun  suffers  on  its  course  loss 
of  certain  shades  of  colour  through  absorption.     Accordingly 


Infra 
[Red 


Red        Yellow  Green 


Violet 


Ultra-violet 


A      B      C    D     E    F 


Fig. 


G  H  H'      I    M    O  R 

— Solar  Spectrum. 


S     T      U 


the  solar  spectrum  is  an  absorption  spectrum,  and  the  Fraun- 
hofer lines  will  show  which  gases  are  contained  in  the  sphere  of 
light. 

Spectrum  analysis,  by  enabling  us  to  examine  the 
chemical  composition  of  distant  bodies,  especially  of  the 
heavenly  bodies,  has  led  to  most  important  results. 
Further,  by  its  intense  sensitiveness  to  the  slightest  trace 
of  an  element,  it  has  led  to  the  discovery  of  a  whole 
range  of  new  elements. 

The  careful  measurements  of  Kirchhof,  Thalen, 
Huggin,  Dewar,  Abney,  Eder,  Valenta,  Exner,  Kayser, 
etc.,  have  determined  the  wave-length  of  the  light  emit- 
ted by  various  elements.     I'hus: 

Na  shows  a  bright  yellow  double  line,  the  so-called 
D  line.    (  ^  =  5896.16  and  5890.19). 
Li  shows  red  lines  (6708  and  6104). 
Ba  emits  green  light;  its  main  lines  are:  6497,  6142, 
5828,  5536,  etc. 
Lines  A  to  H  in  the  spectrum  are  the  most  readily  recog- 
nisable.    The  eye  is  most  sensitive  to  the  light  between  D  and 


PHOTOTHERAPY  387 

E,  that  is,  part  of  the  yellow;  from  that  point  towards  either 
end  the  light  is  less  and  less  visible,  until  the  red  rays  beyond 
A  and  the  ultra-violet  beyond  H  are  hardly  distinguishable. 

Our  visual  organs  then  are  limited  In  range,  like  our  organs 
of  hearing  (we  cannot  hear  sound  waves  of  less  than  i  mm.). 
D'Arsoincd  thus  explains  the  insensibility  to  his  currents. 

It  does  not,  therefore,  follow  that  the  light  rays  of  either 
greater  or  less  wave-length  have  less  intensity  of  vibration.  As 
a  matter  of  fact,  as  Herschel  showed,  the  heat  of  sun  rays 
increases  towards  the  red  and  goes  on  increasing  in  the  dark 
space  beyond. 

§48.  By  the  aid  of  an  intensely  sensitive  instrument  (the 
bolometer,  based  on  the  principle  that  a  wire  offers  increased 
electric  resistance  with  increase  of  temperature)  which  regis- 
ters heat-differences  to  the  millionth  part  of  a  Celsius  degree, 
Langley  discovered  a  heat  spectrum,  almost  20  times  as  long 
as  the  vnsible  spectrum,  extending  beyond  the  red.  In  this  heat 
spectrum  there  are  about  700  "lines  of  cold"  (reminding  one 
of  the  Fraiinhofer  dark  lines),  where  the  bolometer  marks  no 
heat. 

The  wave-length  of  the  heat  rays  that  have  been  examined 
ranges  from  0.7 /^  to  5.2  ji  (n  =  toVo  mm). 

The  heat  spectrum,  as  exammed  by  the  bolometer,  shows  a 
constant  change  of  temperature,  at  longer  and  shorter  intervals. 
Ihe  spectrum  shows  lines  corresponding  to  the  sudden  fall  and 
rise  of  the  temperature;  the  broader  bands  of  lower  tempera- 
ture m.ay  be  regarded  as  absorption  bands.  Langley' s  further 
investigations,  at  a  height  of  4,000  metres  on  Mount  Whitney, 
proved  that  a  great  deal  of  heat  is  absorbed  by  the  atmosphere; 
he  was  able  at  the  same  time  to  determine  the  amount  of  solar 
heat  reaching  our  atmosphere. 

This  amount  is  so  great  that,  if  the  rays  struck  vertically, 
it  would  thaw  in  one  minute  an  ice  crust  of  nearly  3  centimetres. 
The  thickness  of  the  atmosphere  which  the  sun's  rays  have  to 
penetrate  varies  at  different  times  of  the  day  (it  is  much  less 
at  noon  than  at  sunset)  ;  hence  the  spectra  vary  correspondingly. 
Rays  of  short  wave-length  suffer  most  absorption.  At  noon  the 
heat  maximum  is  at  orange,  in  the  evening  towards  red.     The 


388 


RADIO-THERAPY 


character  of  the  heat  spectrum  varies  also  at  different  seasons 
of  the  year. 

Further  investigation  of  the  heat  spectrum  may,  in  Lang- 
ley's  opinion,  have  important  results  for  meteorology.  Both 
the  quality  (/.  c,  the  rate  of  vibration  of  emitted  rays)  and  the 
intensity  of  heat  radiation  from  bodies  are  dependent  on  their 
temperature,  their  chemical  nature,  and  the  character  of  their 
surface. 

Of  the  heat  rays  striking  a  body  part  are  reflected,  part 
penetrate  the  body.  A  diathermanous  body  is  one  which  allows 
the  penetrating  rays  to  pass  through;  an  athermanous  body  is 
one  which  absorbs  them  wholly  or  in  part. 

Since  glass  does  not  allow  of  the  passage  of  rays  of  long 

/ 


TJltra-red  Red  Orange  Yellow       Green       Blue       Indigo       Violet       Ultra-Violet 

Fig.  89. — From  A.  Laincr's  Lectures  on  photograph,  opt.,  Vienna,  1890,  p.  107. 

wave-length,  i.  c,  of  heat  rays,  prisms  of  rock-salt  or  fluorspar 
must  be  used  in  these  investigations. 

§  49.  Rays  in  the  almost  invisible  part  of  the  spectrum  from 
H  to  R  act  che^nically  on  many  light-sensitive  preparations. 
Bromide  of  silver  is  affected  at  F,  iodide  of  silver  at  G.  On 
the  whole,  chemical  action  is  strongest  at  //,  and  lessens  in 
either  direction.  (On  Fig.  89,  line  a,  b,  c  gives  the  curve  of 
thermal  action,  line  d,  e,  f,  g  the  curve  of  the  chemical  action; 
line  h,  i,  k  gives  the  light  curve,  with  its  maximum  at  yellow.) 
This  is  true  only  of  the  solar  spectrum;  the  spectrum  of  each 
light  source  varies.  The  spectrum  of  Driimond's  limelight  and 
that  of  the  electric  arc-light  extend  much  further  towards  the 
ultra-violet  end  than  the  solar  spectrum,  because  of  the  great 
absorption  by  the   atmosphere  of  the  short-waved  sun   rays. 


PHO  TO  THERAPY  389 

(The  amount  of  ultra-red  rays  in  sunlight  depends  on  the 
amount  of  vapour  and  carhonic  acid  in  the  atmosphere.)  Still 
more  ultra-violet  is  shown  in  the  spectrum  of  the  sparks  of  an 
induction-coil;  most  of  all  in  the  spectra  of  aluminium,  cobalt, 
iron  or  Eder's  alloy  (lead,  zinc,  cadmium).  These  are  line 
spectra,  showing  innumerable  lines,  especially  in  the  ultra-violet. 
The  spectrum  of  iron,  c.  g.,  has  about  5000  lines. 

Amongst  the  media  which  have  been  so  far  examined, 
rock-crystal,  white  fluorspar,  and  calkspar  have  no  appre- 
ciable absorptive  power  for  ultra-violet;  rock-salt,  ice, 
alkali-sulphates,  -carbonates,  -arseniates,  and  -borates, 
alkaline  earths,  soluble  compounds  of  fluorides, 
chlorides  and  bromides  of  the  alkalies  and  alum  have 
very  little.  Ultra-violet  rays  pass  without  appreciable 
diminution  through  the  flame  of  a  candle  and  through 
pure  hydrogen  {ScJiumann) . 

Organic  acids  and  their  compounds,  and  especially 
many  benzol  derivations  {Hartley) ^  have  great  absorp- 
tive power.  Glass,  mica,  gypsum,  gelatine,  and  many 
animal  and  vegetable  liquids  absorb  ultra-violet  largely 
{de  Chardonnet)^ {thus^e.  g., watery  vapour  absorbs  all 
waves  of  less  length  than  307  fifi) .  Huid  albumen  (/'.  e., 
a  12%  solution)  absorbs,  according  to  G.  P.  Dross- 
bach,  all  waves  of  less  than  320  ju//,  and,  when  much 
diluted,  all  of  less  than  300  nn-  A  1%  solution  of  pep- 
ton-gelatin  is  permeable  in  the  same  degree  as  an  equiva- 
lent solution  of  albumen. 

Heavy  flint  glass  and  all  kinds  of  dense  lead-contain- 
ing glass  are  most  absorbent,  crown  glass  and  baryt- 
flint-glass  less  so. 

Cornu  proved  that  a  quartz  prism  gives  a  solar 
spectrum  stretching  beyond  R  in  the  ultra-violet;  a  calk- 
spar }:)rism  gives  the  spectrum  to  beyond  P,  light  flint- 
glass  towards  A'^  in  the  ultra-violet,  whilst  heavy  flint 
glass  stops  short  of  even  all  the  visible  violet. 


')   Compt.  rend.,  1881,  Vn].  XDIII,  p.  406. 
*)    Deutsche  med.  VVocli.,  NdviiiiIiit  ji,   lyoi. 


390  RADIO-THERAPY       . 

Schumann's  experiments  showed  that  a  glass  plate 

0.125  mm.  in  thickness  absorbs  a  third  of  the  extreme 

ultra-violet  rays  of  the  magnesium  spark    (more  than 

A  =277).^) 

Ultra-violet  rays  are  refracted,  i.  c,  gatherea,  by  quartz, 

rock-salt,  or  fluorspar  lenses. 

Ultra-violet  rays,  like  the  short-waved  rays  of  the  visible 
spectrum,  can  produce  fluorescence.  Cathode-  and  Becquerel- 
rays  make  the  air  light-conductive  and  convert  its  oxygen  into 
ozone,  and  ultra-violet  rays  of  short  wave-length  (;A,=  0.00014 
—  0.00019  mm.)  have  the  same  effect. 

Herz  found  that  irradiation  with  ultra-violet  light 
does  away  with  the  oscillatory  character  of  the  discharge 
from  an  apparatus  emitting  electric  waves.  We  may 
imagine  the  layer  of  gas  between  the  two  ends  of  the 
conductor  as  becoming  conductive  through  the  splitting 
up  of  the  electrically  neutral  molecules  by  the  impinging 
corpuscles^).  Following  up  this  discovery,  Hall- 
wachs  found  that  negatively  charged  metal  surfaces 
are  discharged  by  ultra-violet  rays.  Lenard^)  discov- 
ered that  the  negatively  charged  "corpuscles"  of  a  metal 
surface  Irradiated  by  ultra-violet  light  oscillate  so  vio- 
lently In  sympathy  that  they  are  thrown  off  from  the 
surface  at  a  great  rate,  showing  all  the  characteristics 
of  the  ordinary  cathode-rays  produced  by  an  electric 
discharge.  The  negative  electric  charge  of  a  body  Is, 
thus,  under  the  influence  of  ultra-violet  rays,  transmuted 
Into  cathode-rays,  which  pass  off  into  space,  at,  however, 
^     a  noticeably  lower  rate  than  light  rays. 

Side  by  side  with  the  normal  dispersion  of  light  there 
Is,    exceptionally,    an    abnormal    dispersion,    when    the 


^)  /.  M.  Edcr's  Ausfuehr.  Handb.  d.  Phntog.,  I,  i,  pp.  213,  283. 

")  See  Lampa,  Ueber  Stromunterbrechung  mit  besonderer  Beriicksich- 
tigung  des  W chnclts,ch.en  Unterbrechers,  Sitzungsber.  d.  Kaiserl.  Akademie 
d.  Wissensch.,  Vienna,  1901. 

*)  Annalen  d.  Physik,  1900,  Vol.  Ill,  p.  298. — Drudc's  Ann..  Vol.  i,  1900, 
p.  486. — Sitzungsber.  d.  Kaiserl.  Akad.  d.  Wissensch.,  math.-naturw.,  CI, 
October  19,  1899. 


PHO  TO  THERAPY  39 1 

sequence  of  colours  and  lines  In  the  spectrum  is  wholly 
dilierent  from  that  of  normal  dispersion.  When  a 
fuchsin  alcoholic  solution  is  used,  as  the  prism  violet  is 
least  diffracted,  then  red,  then  yellow,  green  and  blue- 
green  are  quite  absorbed. 

The  position,  too,  of  the  spectrum  lines  may  be 
changed. 

Humphreys  and  Mohler  found  that  when  the  source 
of  light  burns  under  pressure  the  lines  are  always  shifted 
slightly  towards  the  red. 

Further,  P.  Zeemaun  discovered  that  when  the  light 
source  is  brought  under  strong  magnetic  influence  the 
spectrum  lines  show  peculiar  changes;  according  to  the 
point  of  view,  they  appear  either  doubled  or  trebled, 
with  fixed  ratios  of  polarisation. 
§  50.   The  term  interference  of  li^^lit  is  applied  to  the  phe- 
nomena resulting  from  the  mutual  effect  of  light-waves  meeting 
each  other. 

The  interfering  waves  strengthen  or  weaken  each  other  in 
proportion  to  the  variance  in  their  rate  of  progression.  Hence 
with  homogeneous  light  a  series  of  alternate  light  and  dark 
bands,  with  white  light,  a  series  of  spectra,  is  obtained. 

The  colours  of  thin  plates,  due  to  interference,  enable  us  to 
calculate  the  wave-length  of  the  light  used. 

§  51.  Deflection  or  diffraction  of  lijrht  results  when  light  is 
passed  through  a  narrow  aperture  or  past  a  thin  rod;  the  light 
is  then  transmitted  slightly  on  one  side,  thereby  giving  rise  to 
interference  phenomena. 

If  homogeneous  light  be  used  a  bright  band  of  the  same 
colour  as  the  light  will  be  seen,  with  alternate  bright  and  dark 
bands  on  either  side.  If  white  light  be  used,  a  white  band  will 
appear,  with  colour  bands  to  right  and  left  of  it.  A  }iratin\r 
is  a  series  of  narrow  parallel  apertures,  made  either  with  (me. 
wires  stretched  at  equal  distances  across  (wire  grating),  or  by 
scratching  parallel  lines  on  a  soot-blackened  glass  plate,  or  on 
an  ordinary  glass  plate  with  a  diamond  (glass  grating).  If 
white  light,  admitted  through  an  aperture,  is  passed  through  n 
grating,  and  the  image  is  projected  on  a  screen,  brilliant  spectra 


392  RADIO-THERAPY 

are  seen  on  either  side  of  the  white  centre,  the  direct  Image  of 
the  aperture. 

In  the  spectrum  nearest  to  the  centre  the  colours  are  clear, 
and  the  red,  yellow,  green,  and  blue  bands  are  of  approximately- 
equal  breadth.  The  first  spectrum  is  the  clearest  and  brightest, 
the  second  is  broader,  the  following  ones  are  blurred.  The 
same  phenomena  are  observed  when  the  light  is  reflected  from 
a  scratched  surface.  The  reflection  gratings  most  in  use  now  are 
metal  mirrors  with  very  numerous  fine  scratch-marks  (700  to 
the  millimetre) . 

The  metal  is  polished  and  concave,  so  as  to  serve  at  the 
same  time  as  a  mirror,  giving  back  the  images  of  the  aperture 
without  a  lens.     These  are  concave  gratings. 

The  diffraction  spectrum  obtained  from  this  apparatus  has 
not  only  the  advantage  of  being  uninfluenced  by  absorption  (an 
important  point  in  investigations  of  ultra-violet,  which  is  so 
much  absorbed  by  glass  prisms),  but  it  has  also  the  further 
advantage  over  the  refraction  spectrum  of  giving  a  deflection 
of  the  rays  proportional  to  their  wave-length.  The  refraction 
spectrum  gives  a  quite  disproportionate  deflection  of  the  more 
refrangible  rays,  so  that  the  blue  end  is  much  broader  than 
the  red. 

The  identity  of  heat  rays  and  ether  vibrations  is  proved  by 
the  observation  or  similar  interference  phenomena  in  the  visible 
and  in  the  ultra-red  (/.  e.,  heat)  and  the  ultra-violet  rays. 

§  52.  Electro-magnetic  vibrations  of  any  wave-length  are 
capable  of  affecting  chemical  processes.  K.  Schaurn^)  showed 
that  under  the  influence  of  electro-magnetic  vibrations: 

1.  Processes  are  accelerated  which  go  on  in  the  dark  also 
(crystallisation,   formation  of  HCl  from  H-.  -\-  CI.) . 

2.  Processes  are  brought  about  which  require  light  (de- 
composition of  silver  halogenide  into  silver  and  sub-haloid)  ; 
many  of  these  are  reversed  again  in  the  dark  (phototropy) . 


^)    Sitzgsber.  d.  Gesellsch.  z.  Bcfocrdcrg.  d.  Naturwissensch.  zu  Marburg, 
No.  9,  July,  1901. 


PHOTOTHERAPY  393 

Processes  influenced  or  caused  by  light  may  be  due  to  either 
exothermal  (/'.  e.,  heat-producing)  or  endothermal  (/.  <•.,  heat- 
absorbing)   reaction. 

It  was  formerly  held  that  the  red  end  of  the  spectrum  had 
special  thermal  properties;  the  centre,  where  yellow,  orange  and 
green  seem  brightest  to  the  eye,  especially  optical;  and  the  vio- 
let especially  chemical. 

It  is  a  fact  that  \iolet,  blue,  and  even  green  light  has  a  pre- 
ponderating effect  on  all  preparations  used  in  photography,  and 
these  rays  are  called  (following  JFollaston)  the  chemically 
effective  or  actinic  rays. 

Yet  recent  investigations  have  proved  that  no  colour  is  abso- 
lutely ineffective  chemically;  the  outermost  red  and  even  ultra- 
red  affects  silver  salts;  indeed,  red  light  affects  many  substances 
more  powerfully  than  violet. 

Again,  according  to  recent  investigations,  heat  is  no  peculiar 
characteristic  of  the  less  refrangible  red  and  ultra-red  rays,  but 
is  distributed  over  all  parts  of  the  spectrum. 

Thus  all  the  light  rays  of  the  spectrum  may  be  chemically 
effective  and  be  absorbed  by  sensitive  preparations. 

These  chemical  effects  are  as  follows: 

1.  Under  certain  conditions  light  produces  molecular 
changes,  resulting  in  allotropic  modifications,  or  isomeric  com- 
binations. Thus,  yellow  phosphorus  is  transformed  by  heat  or 
light  into  red. 

2.  Light  has  the  power  of  setting  up  processes  of  chemical 
combination. 

Equal  volumes  of  chlorine  and  hydrogen  will  not  combine 
in  the  dark,  but  will  combine  explosively  in  the  light  to  form 
HCl. 

Light  very  often  favours  oxidation  (cf.  bleaching,  the 
fading  of  many-coloured  materials  in  light). 

3.  Light  causes  chemical  decomposition.  The  most  notable 
instance  of  this  is  with  chlorophyll,  the  green  colouring  matter 
in  plants.  In  sunlight  chlorophyll  decomposes  the  carbonic-acitl 
gas  of  the  air,  absorbing  the  carbon,  which  plants  need  for 
growth,  and  giving  out  again  the  oxygen  necdctl  in  the  air. 


394  RADIO-THERAPY 

This  action  of  chlorophyll  takes  place  only  in  the  light,  and 
depends  on  absorption,  mainly  of  the  red  rays,  as  is  shown  by 
the  absorption  spectrum. 

Photographic  processes  are  of  the  same  nature,  depending 
mostly  on  the  reduction  of  metallic  salts,  usually  haloid  com- 
pounds of  silver. 

Each  of  the  spectrum  colours  has  both  an  oxidising  and  a 
reducing  effect;  but  red  light  affects  metallic  compounds  for  the 
most  part  by  oxidation,  violet  light  by  reduction.  Organic 
compounds  are  usually  most  powerfully  oxidised  by  violet  light, 
and  pigments  by  the  special  light  which  they  absorb. 

Photographic  preparations  {AgBr,  AgCl,  etc.)  are 
decomposed  not  only  by  the  light  they  absorb  of  themselves,  but 
also  by  the  light  they  absorb  by  reason  of  the  admixture  of  cer- 
tain substances  (optical  sensitisers) . 

These  substances  (chemical  sensitisers)  favour  decomposi- 
tion by  light  by  binding  chemically  the  constituents  (bromine, 
iodine,  oxygen,  etc.)  eliminated  by  light. 

Artificial  light-sources,  being  very  unequal  in  actinic  rays,  do 
not  affect  the  photographic  plate  in  proportion  to  their  visible 
optical  strength.  According  to  Eder's  table,  e.  g.,  both  the  mag- 
nesium and  the  electric  arc-light  have  more  than  20  times  as 
much  actinic  effect  as  lamplight  of  apparent  brilliancy. 

The  effect  of  the  coloured  rays  depends  on  the  intensity  and 
the  nature  of  the  light  and  its  duration,  and  on  the  nature  and 
molecular  condition  of  the  Illuminated  body.  Each  wave- 
length (i.  e.,  color)  has  its  own  chemical  effect.  No  ray  is 
effective  unless  it  is  absorbed.  The  course  of  photochemical 
reaction  may  be  influenced  by  rise  of  temperature,  pressure,  and 
electricity. 

Physiological  Effects  of  Light. 

§  53.  By  the  "physiological  effects  of  light"  are  usually 
understood : 

I.  Its  physical  effect  on  matter,  on  the  elementary  particles 
of  which  the  tissues  are  composed.  Such  physical  and  chemical 
processes  are  various,   and  may  reveal  themselves  as  optical. 


PHOTOTHERAPY  395 

chemical  and  heat  effects.  We  know  that  light  may  produce 
fluorescence,  phosphorescence,  electric  phenomena  and  other 
physical  processes. 

2.  Its  effect  on  the  vital  functions.  Under  the  influence  of 
light  living  tissues  may  pass  from  a  state  of  passivity  to  one 
of  activity,  and  change  of  form,  of  energy,  of  matter  may  be 
induced.  In  this  sense,  light  works  like  other  physiological  irri- 
tants, under  certain  conditions  awakening  and  strengthening  ele- 
mentary forms  of  life,  under  others  weakening  or  annihilating 
them. 

These  two  main  effects  of  light  stand  in  causal  relation  to 
each  other. 

According  to  Loch,'')  light  is  not  merely  an  irritant  in  the 
physiological  sense:  it  actually  infuses  the  organism  with 
energy.  This  energy  is  transmuted  into  other  forms,  for  the 
most  part  of  a  chemical  nature;  morphological  differences,  even 
chemical,  require  an  organ. 

In  general  the  physiological  effects  of  light  are  great  in 
proportion  to  the  intensity  and  duration  of  the  energy  at  work. 
In  many  cases,  however,  the  shorter  the  process,  the  more  pow- 
erful is  the  effect  of  intense  light.  Analogies  to  this  may  be 
found  in  the  effect  of  sudden  fluctuations  of  temperature  or  of 
electric  currents. 


The  Effect  of  Light  on  Plants  "). 

§  54.  Plants,  more  than  any  other  living  organism,  need 
light.  Without  it  they  cannot  take  from  the  air  the  indispensa- 
ble carbonic  acid,  nor,  by  means  of  chlorophyll,  assimilate  it, 
giving  out  the  freed  oxygen  and  retaining  the  carbon  in  new 
combinations,  such  as  sugar,  gum,  starch,  cellulose,  albumen''). 

There  are  two  theories  as  to  the  way  light  works.     Most 


')  PHugcr's  Archiv,  1896,  Vol.  LXIII. 

^)   From  C.  Mueller  and  H.  Potoni,  Botanik,  Berlin,  1893,  p.  260. 

■""j  It  can  be  chemically  proved  that  the  amount  of  carbonic  acid  taken 
from  the  air  by  leaves  in  sunlight  is  precisely  the  same  as  the  amount 
of  oxygen  given  ofif.  Without  sunlight  leaves  add  to  the  amount  of  COi 
in  the  air. 


396  RADIO-THERAPY 

physiologists  assume  a  direct  photochemical  effect  on  the 
chlorophyll,  an  effect  dependent  on  the  intensity  and  the  quality 
of  the  light. 

For  each  plant  there  is  a  certain  degree  of  light  intensity 
most  helpful  to  its  assimilative  process;  certain  plants  (shade- 
loving  plants,  marine  algae  growing  at  a  great  depth)  flourish 
best  in  a  dim  light,  others  (light-loving  plants)  prefer  sunny 
places. 

The  quality  of  the  light  needed  for  the  "chlorophyll  func- 
tion" coincides  with  that  demanded  for  certain  physical  and 
chemical  processes.  The  photochemical  effect  of  light  is  usually 
ascribed  to  the  indigo  and  violet  rays  (/'.  e.,  the  more  refrangi- 
ble and  short-waved  rays). 

In  the  decomposition  of  carbonic  acid  by  chlorophyll,  it  is 
just  the  red  and  yellow  rays  (/'.  e.,  the  less  refrangible)  which 
are  effective. 

The  chlorophyll  pigment  can  only  be  found  in  light ;  plants 
and  plant-parts  grown  in  the  dark  have  no  chlorophyll,  but  are 
pale  yellow  in  colour  {etiolation) .  But  artificial  light  sources, 
such  as  the  flame  of  candles,  gas,  oil  lamps  and  the  ray  of  the 
electric  arc-light,  may  take  the  place  of  sunlight  here;  they  all 
have  the  yellow  rays  needed  for  chlorophyll.  The  quantity  of 
light  need  not  be  large.  JViesner  proved  that  sprouting  plants 
will  grow  dark  green  in  a  light  which  barely  suffices  for  the 
reading  of  large  print. 

The  chlorophyll-producing  property  of  light  was  deter- 
mined by  means  of  Peletier' s  bell-jars,  vessels  filled  with  col- 
oured solutions  to  allow  the  passage  of  the  desired  rays  alone. 

Pringsheim's  theory  of  chlorophyll  is  opposed  to  the  more 
widelyaccepted  viewof  direct  photochemical  effect.  He  holds  that 
the  chlorophyll  pigment,  by  absorbing  the  blue,  violet  and  ultra- 
violet rays,  without  being  itself  decomposed,  acts  as  a  kind  of 
light  screen,  lessening  the  degree  of  respiration  (/'.  c,  the  oxida- 
tion connected  with  the  elimination  of  CO.)  and  increasing  pro- 
portionally the  assimilative  processes,  especially  the  collecting 
of  carbon  and  giving  off  of  oxygen,  going  on  within  the  plasma 
of  the  chlorophyll  body. 

There  are  always  changes  of  energy  corresponding  with  the 


PHOTOTHERAPY  397 

changes  of  matter  brought  about  in  plants  by  light  ' )  ;  they  are 
often  more  noticeable  than  the  changes  of  matter.  Trans- 
formation of  energy  in  plants  shows  itself  in  movement,  of  which 
two  great  groups  may  be  distinguished,  gro-ivth-movoncnt  and 
irritabUity-movemeut.  In  the  latter  are  comprised  all  the  proc- 
esses in  which  a  change  of  position  of  the  irritated  part  is 
brought  about  by  any  physical  reaction. 

Light  is  needed  for  many  growth  phenomena,  but  not  for  all. 
It  is  unnecessary  for  germination,  for  the  growth  of  roots  and 
many  blossoms,  as  well  as  for  the  flourishing  of  many  endo- 
phytic (living  in  the  body  of  plants)  and  endozoic  (living  in 
the  body  of  animals)  living  parasites.  In  general  light  has  a 
retarding  effect  on  growth,  both  as  regards  rate  and  extent 
(this  holds  good  also  of  organs  which  are  above  ground) .  This 
explains  the  varying  rate  of  growth  at  different  hours  of  the 
day,  a  rate  which  is  not  for  a  time  immediately  influenced  by 
artificial  exclusion  of  light.  The  growth  of  stems  and  leaves  is 
on  the  whole  least  towards  evening,  most  towards  or  in  the 
morning. 

Van  Tieghem  ')  showed  that  all  light  rays  except  the  red 
and  ultra-red  retard  and  lessen  the  growth  of  plants,  and  that 
the  effect  is  most  pronounced  in  the  rays  that  are  most  refracted 
in  the  spectrum.  This  phenomenon  may  be,  conditionally, 
regarded  as  a  paralysing  effect  of  the  more  refrangible  rays. 
According  to  Flammarion.^)  the  colour,  too,  of  flowers  is  influ- 
enced by  different  light  rays,  so  that,  e.  g.,  very  various  shades 
of  the  lilac  may  be  obtained  under  variously  coloured  light.  But 
the  effect  is  greatest  on  the  scent.  Thus,  strawberries  grown 
under  red  glass  had  a  wonderful  aroma,  and  crassula  flowers, 
which  are  nearly  scentless  in  ordinary  sunlight,  emitted  a  deli- 
cate fragrance,  like  that  of  bananas,  under  the  influence  of  red 
light. 


')  Augustus  Waller  proved  that  light  develops  electro-motive  energy  in 
the  assimilating  leaf,  more  by  the  bright  red  rays,  especially  those  absorbed 
by  the  chlorophyll,  than  by  the  heat  rays.  (Compt.  rend,  de  la  soc.  dc  biolog.. 
1900.  LIT.  p.   1093.) 

')  Traite  de  Botanique,  Paris.   1S89. 

°)  Gcbhard,  Die  Heilkraft  dcs  Lichtcs,  Leipzig,  1898.  p.  44. 


398  RADIO-THERAPY 

The  way  in  which  hght  affects  extent  of  growth  is  shown 
most  clearly  by  the  fact  that  plants  grown  in  the  dark  have 
abnormally  long  internodes  and  leaf  stems,  but  no  leaf  surface. 
All  green  leaf  surfaces  are  furthered  in  their  growth  by  light 
through  the  effect  of  light  on  the  assimilation  of  carbonic 
acid. 

We  must  carefully  distinguish  between  the  heat  effect  and 
the  chemical  effect  of  light  (thermal  and  photo-chemical 
effect) . 

Amongst  specific  growth  movements  due  to  light  may  be 
noted  certain  forms  of  nutation  and  heliotropism.  In  so  far  as 
light  in  these  cases  acts  as  the  stimulus,  these  movements  may 
also  be  regarded  as  irritation  phenomena. 

Nutation  is  the  term  applied  to  the  automatic  movements 
made  once  or  repeatedly  within  a  certain  given  period  by  certain 
growing  parts  of  a  plant. 

A  special  class  of  these  periodic  nutation-movements  are 
the  sleep-movements  (nyctitroplc  nutations)  made  by  the  green 
leaves  of  certain  plants  towards  sundown.  In  the  daytime  the 
leaflets  are  spread  open  in  such  a  position  that  the  light  rays 
impinge  vertically;  at  night  they  close  up  and  fold  themselves 
either  upwards  or  downwards,  according  to  their  kind, 
against  the  common  stem.. 

Heliotropism  is  the  faculty  possessed  by  many  parts  of 
plants  of  turning  towards  or  away  from  the  ciirection  of  the 
strongest  light. 

Stems  and  leaf  stalks  are  usually  positively  heliotropic,  i.  c, 
they  grow  towards  the  light  source  in  the  direction  of  the  light 
rays. 

Roots  and  rhizomes  are  almost  all  negatively  heliotropic, 
/'.  e.,  they  turn  away  from  the  light  source. 

Green  leaf  surfaces  show  transverse  or  dia-heliotropism, 
i.  €.,  they  turn  themselves  at  right  angles  to  the  direction  of  the 
light. 

Parts  of  plants  removed  from  their  normal  position  make 
curved  heliotropic  movements. 

Heliotropic  properties  are  dependent  on  the  degree  of 
brightness  of  the  light.     In  a  very  glaring  light  organs  usually 


PHOTOTHERAPY  399 

positively  heliotropic  may  become  negatively  so.     Heliotropic 
curvature  is  conditioned  by  the  direction  of  the  incident  light. 

We  may  regard  as  movements  of  irritability  purely  many  of 
those  locomotor  increments  which  light  frequently  induces  in 
plants. 

Many  unprotected  plasmic  bodies,  such  as  the  swarm  spores 
of  many  algze,  are  capable  of  independent  movement  by  means 
of  wavmg  cilia.  The  direction  of  the  movement  depends  partly 
on  temperature-effects  and  partly  on  the  action  of  the  incident 
light. 

Light  is  the  cause  of  change  of  place  with  the  microscopic 
inhabitants  of  the  ocean,  ponds  and  lakes,  as  v>ith  the  larger 
animals;  they  are  attracted  by  it,  and  in  sunlight  rise  from 
the  depths  to  the  surface.  Very  often  they  are  present  there 
in  such  large  numbers  that  the  water  loses  its  natural  clearness, 
transparency,  and  colourlessness,  and  appears  dull-green,  bluish, 
brown,  or  red.  This  phenomenon  is  termed  the  "flowering  of 
the  water."  The  rising  of  the  water  plants  to  the  surface  is 
due,  in  part,  however,  to  their  lessened  specific  gravity  through 
the  production  of  oxygen,  and,  amongst  the  threads  of  the 
algae,  or  in  the  higher  forms,  in  the  air  passages  or  cavities. 
Those  reproductive  cells  of  the  algas  (swarm  spores,  zoospores) , 
which,  like  the  infusoria,  are  capable  of  independent  movement 
by  means  of  waving  cilia,  show  heliotropic  movement,  /.  e.,  they 
move  as  far  as  possible  in  a  straight  line  towards  the  source  of 
light.  A  few  kinds  are  negatively  heliotropic  and  are  repelled 
by  light.  The  movements  of  swarm  spores  are  connected  with 
a  turning  on  the  longitudinal  axis  of  their  body;  whether  to 
right  or  left  depends  again  on  the  light  rays.  The  more  quickly 
vibrating  blue  rays  alone  influence  the  direction  of  the  move- 
ment (heliotropic  action)  ;  red  rays,  like  darkness,  do  not  affect 
it  at  all. 

The  creeping  or  ama4-)oid  movements  of  the  plasmodia  of 
myxomycetes,  as  of  flowers  of  tan,  arc  dependent  on  light; 
these  bodies  are  negatively  hehotropic,  working  themselves 
slowly  along  on  their  base,  away  from  the  bright  spots  into  the 
shade. 

On  this  plasma-movement  arc  possibly  dependent  the  move- 


400  RADIO-THERAPY 

merits  of  chlorophyll  bodies,  which  bear  some  relation  to  the 
greater  or  less  intensity  of  the  light. 

Portions  of  the  green  leaves  of  phanerogams,  mosses  and 
the  prothallia  of  ferns  which  have  been  kept  continuously  in 
deep  shade,  assume  a  darker  shade  on  account  of  slow  changes 
of  position  in  the  chlorophyll  corpuscles  in  the  protoplasm. 
These  corpuscles  under  the  influence  of  light,  especially  of  the 
short-waved  rays,  collect  mainly  in  the  cell-surfaces  turned 
towards  the  surface  of  the  leaf;  in  the  dark  they  collect  mainly 
along  the  side-walls  of  the  cells,  at  right  angles  to  the  cell- 
surface.  It  is  uncertain  whether  we  have  here  a  direct  influence 
of  light  on  the  protoplasm,  or  an  indirect,  induced  possibly  by 
primary  change  in  the  chlorophyll  corpuscles. 

Borodin  distinguished  between  day-position  and  night-posi- 
tion. Stahl  divides  the  position  of  the  (for  the  most  part)  flat 
chlorophyll  corpuscles  with  regard  to  light  incidence  into  "sur- 
face-position" and  "profile-position."  In  all  cases  the  position 
of  chlorophyll  corpuscles  is  governed  by  the  following  general 
rule : 

With  a  medium  degree  of  brightness  the  chlorophyll  cor- 
puscles turn  so  as  to  present  the  broadest  possible  surface  to 
the  light  rays.  With  a  minimum  of  brightness  {i.  c,  dark- 
ness) and  a  maximum  of  brightness  {e.  g.,  direct  sunlight) 
they  turn  their  narrow  edge,  i.  e.,  the  least  possible  surface, 
to  the  light. 

Locomotor  movement  is  the  property  of  the  chlorophyll 
bodies  in  all  assimilating  tissues. 

Corresponding  to  the  general  rule  for  locomotor  movement 
is  the  form-change  of  chlorophyll  corpuscles,  depending  on 
degree  of  brightness.  They  are  flattest  in  the  most  favour- 
able light.  They  are  capable  of  contraction.  Hence  a  green 
plant  may  take  on  a  lighter  or  darker  green  shade  accord- 
ing to  the  degree  of  light  (just  as  a  chameleon  changes  its 
colour) . 

The  protoplasmic  current  in  plant-cells  seems  under  ordinary 
conditions  to  be  independent  of  light,  though  it  is  conditioned, 
as  may  be  proved,  by  temperature,  the  amount  of  water  con- 
tained, or  presence  of  oxygen,  and  Is  frequently  only  recognis- 


PHO  TO  THERAPY  40 1 

able  under  the  microscope  after  being  accelerated  by  a  mechani- 
cal stimulus. 

According  to  our  present  knowledge,  the  current  in  the  cells 
goes  on  unhindered  by  the  exclusion  of  light.  But  E.  Josinjr  ') 
proved  that  under  changed  external  conditions  the  protoplasmic 
current  may  after  all  be  radically  influenced  by  light.  These 
changed  external  conditions  he  brought  about  in  two  ways: 
first,  by  subjecting  objects  with  freely  flowing  protoplasms  to 
the  effect  of  weak  solutions  of  ether  or  chloroform ;  and, 
secondly,  by  withdrawing,  by  the  aid  of  suitable  agents,  the  car- 
bonic acid  from  the  surrounding  air.  Under  such  external  con- 
ditions the  protoplasmic  current  ceased  to  flow  when  the  light 
was  excluded,  and  resumed  its  course  on  its  re-admission. 

Pringsheim  ')  was  the  first  to  furnish  data  as  to  the  injuri- 
ous effect  of  light  on  plants.  Klcmm  agreed  with  him  in  find- 
ing no  changes  specially  characteristic  of  these  effects.  Rigidity, 
formation  of  nodes,  concretion  of  plasma,  granulations  (espe- 
cially in  the  cell-nucleus)  occur,  but  without  being  specially 
marked  and  characteristic.  The  disorganisation  caused  by 
illumination  differs  from  "death  by  heat"  in  that  no  such 
intensive  corporeal  movements  are  ever  produced  as  in  the  case 
of  sudden  change  of  temperature.  For  the  rest  "light  intensity 
raised  to  its  maximum  tends  directly  towards  precipitation  in 
the  plasma  and  towards  its  rigidity."  Vacuolisation  does  not 
occur;  contraction  occurs  only  in  the  case  of  death  supervening. 


2.    The  Effect  of  Light  on  Bacteria. 

§  55.  In  1877  Dozvncs  and  Blunt'')  first  drew  attention  to 
the  fact  that  diffused,  and,  still  more  direct,  sunlight  has  the 
power  of  killing  putrefaction  bacteria,  that  the  heat  rays  play  no 
part  here,  and  that  the  blue,  violet  and  ultra-violet  rays  take  the 


')   Jahrb.  d.  wisscnscli.  Botanik.  1901,  Vol.  XXVI. 

-)  Jahrb.  f.  vvissensch.  Botanik.  Vol.  XII,  p.  2R8.  (Rcf.  Sclimatis  and 
Albrecht  in  Lubar.sch-O.stcrtag's  Ergcbn.  A.  allgcm.  Pathologic,   1890.) 

')  Proceedings  of  the  Royal  Society  of  London,  Dec.  6.  1877.  Vol. 
XXVI.  p.  488.  and  Dfc.   iglh,   1878.  Vol.  XXVIII.  p.  199. 


402  RADIO-THERAPY 

most  active  share  in  the  effect,  though  the  red  and  orange  rays 
are  not  wholly  inactive.  They  showed  that  the  effect  is  the 
same  whether  the  bacteria  be  damp  or  thoroughly  dried; 
further,  that  the  presence  of  oxygen  is  necessary,  and  that  the 
manner  in  which  the  light  works  in  these  experiments  is  not  to 
be  sought  in  a  modification  of  the  nutritive  basis.  They  took 
into  account  also  the  possibility  that  the  products  of  metabolism 
in  the  bacteria  may  be  influenced  by  light.  These  data,  disputed 
at  first  by  Tyndall,'')  were  soon  confirmed  on  all  sides,  and  a 
large  number  of  fresh  facts  were  added  to  our  knowledge  of 
the  subject.  Whilst  Dowries  and  Blunt  made  their  experiments 
with  any  bacterial  mixture  of  decomposing  liquids  to  hand,  the 
later  investigators  used  pure  cultures.  Later  on,  too,  physical 
conditions  were  taken  more  into  account,  and  the  arrangements 
for  the  experiments  made  more  exact  by  the  use  of  light  sources 
of  varying  intensity,  and  of  light  filters. 

The  fact  that  light  has  a  very  great  power  of  destroying 
bacteria  has  now  been  established.  This  has  been  deduced  from 
the  experim.ents  of  Fatigati^-)  Arloing,^)  Diiclaux,'^)  Liihbert;') 
Janowski,'^)  Santori')  Raspe,^)  Ge'issler^')  Kotliar,^'^)  Dan- 
drieu,^^)  Chmiliewsky,^-)  Gaillard,'')  Marshall  Ward,'*) 
Ledoiid-Ledard,''')     Pansini,''")     d'Arsonval    and    Charrin,'^) 


')   Nature,  Sept.   15th,   1881,  Vol.  XXIV,  p.  466. 

')   Compt.  rend.,  1879,  Vol.  LXXXIX,  p.  959- 

')   Ibid.  Vol.  C,  p.  378,  and  Vol.  CI,  p.  5ii- 

*)   Ibid.   1885. 

')   Ref.  in  Ranm,  Zeitschr.  f.  Hyg.,  Vol.  VI. 

')   Centralbl.   f.  Bakteriologie,   Vol.   VIII,  p.   167. 

0   Boll,  della  Accad.  med.  d'igiene,  Roma,  Vol.  XVI,  p.  386. 

*)  Einfluss  des  Sonnenlichtes  auf  Mikroben.  Dissertation,  Schwerin, 
1891. 

")   Centralbl.  f.  Bakt.,  Vol.  XI,  p.  161. 

'")   Ibid.  Vol.  XII,  p.  836. 

")   Annales  d'Hygiene,   1888,  p.  448. 

^)  Wratsch,  1892,  No.  20. 

^^)  These  de  Lyon,  p.  396. 

")  Proceedings  of  the  Royal  Soc.  of  London,  Vol.  LII,  p.  393,  and  Vol. 
LIII,  p.  23. 

"*)   Arch,  de  medec.  exp.  etc.,  Ser.  i,  Vol.  V,  p.  779. 

")  Riv.  d'igiene,   1889. 

")  Arch,  de  physiologic  norm,  et  patholog.,  Vol.  VI,  p.  335. 


PHO  TO  THERAPY  403 

Roux,^)  Billiugs  and  Peekliam,-)  Kruse,^)  Koch*)  Beck 
and  Schiiltz/')  Dicudonne,'^)  Biichner,')  r.  Esmarch,") 
Giiinti,'')  Martinaiid,'")  Mojtiont,^^)  WittVm'-)  Richard- 
son,^^) SchkkhdJ-dt  '*)  and  Ruhemann^^) .  Most  pathogenic 
bacteria  are  injured  in  their  development  and  growth  or  are 
annihilated  by  light.  This  was  proved  by  Jf'ard  and  Bie  in 
the  case  also  of  moulds  and  yeast-cells.  The  various  kinds 
of  bacteria  are  differently  affected  {Axel  L.  Larsen  "')  )  whilst, 
e.  g.,  the  bacilli  of  typhus,  diphtheria,  plague  and  splenic  fever 
have  comparatively  little  resisting  power,  tubercle  bacilli  and 
staphylococci  offer  greater  resistance.  Some  kinds  are,  indeed, 
said  to  be  directly  favoured  in  their  growth  by  light;  this  was 
observed  in  bacterium  photometricum  {Engelmcnin)  ^  in  certain 
yeast  and  mould  fungi  {Gciillard),  and  in  a  coccus  cultivated 
from  faeces  by  Schenk  '' ) . 

Different  degrees  of  resistance  are  offered  by  the  spores  and 
by  the  bacilli  of  splenic  fever.  The  former  were  killed  by 
Arloing  in  2  hours'  direct  sun-heat,  whilst  he  needed  26-30 
hours  for  the  killing  of  the  bacillus. 

A  degree  of  illumination  which  is  insufficient  for  the 
complete  checking  of  development  may  yet  in  some  cases 
prove    harmful    to    the    formation  of  pigment.      But    in    the 


')   Ann.  de  I'instit.  Pasteur,   1887. 

=)   Centralbl.  f.  Bakt.,  Vol.  XIX,  p.  244. 

')  Zeitschr.  f.  Hygiene,  1895,  322. 

■*)   Ueber  bakteriologische  Forschung,  Berlin   (Hirschwald),   1890. 

'-)  Zeitschr.  f.  Hygiene,  Vol.  XXHI. 

")   Arbeiten  aus  dem  Kaiserl.  Gesundheitsamte.  Vol.  IX. 

')  Centralbl.  f.  Bakt.,  Vol.  XI,  p.  781,  Vol.  XII,  p.  217.  and  Arch.  f. 
Hygiene,  Vol.  XVII. 

")  Zeitschr.  f.  Hygiene,  Vol.  XVI. 

")   Stat.  sper.  agrar.  ital..  Vol.  XVIII. 

'")   Compt.  rend.  Acad.  d.  Sc,  Vol.  CXIII. 

")  Annales  de  I'instit.  Pasteur,  1892. 

^-)   Wiener  klin.  Wochenschr.,  1896. 

'")  Transact,  of  the  Chem.  Soc,  189.3. 

")  Friedreich's  Blatter  f.  gericht.  Med.  1893,  p.  405. 

")  Zeitschr.  f.  diat.  und  phys.  Therapie,  Vol.  IV. 

")   Mittheilungen  aus  Finscn's  mcd.  Lichtinstitut,  I,  p.  89. 

")  Koch's  Jahrcsb.  ueber  die  Fortschr.  in  der  Lchre  von  den  Giihrungs- 
organismen,   1893,  p.  53. 


404  RADIO-THERAPY 

case  of  other  bacteria  again,  as,  c.  g.,  micrococcus  ochro- 
leucus,  light  is  a  necessary  condition  for  this.  Side  by 
side  with  the  checking  of  the  development  of  bacteria,  illumi- 
nation causes  a  lessening  of  the  virulence  of  these  micro= 
organisms.  A  raising  of  the  temperature  makes  the  bacteria 
die  more  quickly  {Geissler,  Bang),  but  that  is  not  necessary  to 
the  process.  Direct  sunlight  has  a  more  powerful  action  than 
diffused  daylight,  but  it  is  weaker  than  simple  or  concentrated 
arc-light.  Arc-light  with  metal  electrodes  {Bang)  and  the 
light  of  the  electric  spark  (Strebel)  have  a  far  stronger  bacteri- 
cidal action. 

Dkudonne  observed  that  bacteria  were  killed  in  half  an 
hour  by  direct  sunlight,  in  6  hours  by  diffused  daylight,  in 
8  hours  by  electric  arc-light  of  900  normal  candle-power,  and 
after  1 1  hours  by  the  electric  incandescent  light.  The  bacteri- 
cidal action  of  sunlight  naturally  varies  with  its  intensity  at 
different  seasons  of  the  year. 

Amongst  the  different  spectrum  rays  the  red  and  the  green 
are  neutral,  or  even,  according  to  some  observers,  favourable  to 
the  growth  of  bacteria;  the  more  refrangible  blue,  violet  and 
ultra-violet  rays,  on  the  other  hand,  have  distinct  bactericidal 
properties.  As  to  how  the  light  acts,  we  assume  ( i )  that  it 
acts  directly  on  the  plasma  of  the  bacteria  themselves;  (2)  that 
it  is  at  the  same  time,  by  producing  photochemical  change,  indi- 
rectly injurious  to  the  nutritive  basis. 

Kriise  found  that  by  subjecting  sterile  nutritive  bases  to 
light  complex  chemical  bodies  (peptones)  were  formed,  which 
checked  development. 

Richardson  proved  that  in  fresh  urine  under  the  influence 
of  direct  ilkimination  peroxide  of  hydrogen  is  formed,  which 
is  decomposed  by  the  bacteria,  the  latter  being  killed  by  the 
liberated  oxygen.  Dieiidonne  showed  that  in  water,  too, 
through  the  action  of  the  chemical  light  rays  peroxide  of  hydro- 
gen is  formed,  most  freely  in  the  upper  layers.  This  compound 
is  strongly  antiseptic.  Under  illumination,  when  oxygen  was 
excluded,  Dieiidonne,  and  also  Tizzoni  and  Cattani,^)   found 


')   Arch.    f.   exper.   Pathologic   iind   Pharmakologie,   Vol.   XXVIII,   p.  59- 


PHOTOTHERAPY  405 

the  bactericidal  action  very  largely  diminished,  which  may  be 
explained  by  the  fact  that  peroxide  of  hydrogen  could  no  longer 
be  formed. 

The  injurious  action  of  light  on  bacteria,  however,  is  not 
due  alone  to  the  fact  that  it  renders  the  nutritive  basis  unsuited 
to  their  growth,  but  to  the  direct  injury  it  inflicts  on  the  pro- 
toplasm. JJ'cird  and  Kriise  proved  that  dried  spores  away 
from  all  nutritive  material  are  also  killed  by  sunlight.  The 
recent  work  of  Finscn,^)  Bic,'-)  S.  Baiig,^) 'a.nd  H.  Strebel*) 
is  interesting,  not  alone  because  it  shows  the  more  powerfully 
bactericidal  action  of  light  sources  with  preponderating  short- 
waved  rays  (concentrated  sunlight  and  arc-light,  F'nisen;  arc- 
light  with  metal  electrodes.  Bang  and  Strebel;  electric  spark, 
StrebeV^)^  but  also  because  in  their  ingenious  experimental  appli- 


^)  Ueber  die  Anwcndung  der  concentrirtcn  chcmischen  Lichtstrahlen  in 
der  IMedicin,  Leipzig,  1899. 

^)    Mittheilungen  aiis  Finscii's  mcd.   Lichtinslitut.   I. 

')    Ibid.   III. 

*)   Deutsche  med.  Wochen.schr.,  1901,  No.  5-6. 

")  G.  O.  Drossbach  has  been  led  by  his  experiments  to  differ  from  others ; 
he  is  extremely  sceptical  as  to  the  parasiticidal  action  of  light,  and  regards  it 
especially  as  impossible  that  bacteria  can  be  affected  by  the  ultra-violet  rays 
at  a  distance  of  even  ^V  mm.  below  the  surface  of  the  skin.  His  experiments 
on  the  influence  of  chemical  (ultra-violet)  rays  on  the  growth  of  bacteria 
yielded  negative  results.  The  inoculated  nutritive  gelatin  was  divided  in 
two  Petri-dishes  which  were  exposed  to  iron  arc-light  (1000  Watt)  at  a 
distance  of  at  most  10  cm.  from  the  arc,  the  one  directly,  the  other  through 
glass,  four  times  a  day  for  two  days  (for  10  minutes  at  a  time) — i.  e.,  for  80 
minutes  altogether.  The  illumination  had  perforce  to  be  intermittent,  as  the 
gelatine  melted  away  when  light  was  applied  for  a  longer  time  at  once.  The 
colonies  developed  in  the  same  way  on  both  gelatine  plates,  the  mould  fungi 
on  the  third  and  the  bacteria  on  the  seventh  most  vigorously.  In  another 
case  a  gelatine  plate  was  subjected  to  direct  rays  six  times  for  so  long  a  time 
as  to  melt  the  gelatine.  After  seven  days  the  colonies  had  developed  normally. 
Evidently  then  the  effect  in  checking  development  is  very  slight,  whether  the 
rays  pass  through  glass  or  through  air  only.  Light  waves  shorter  than  those 
given  by  sunlight  are  hence  of  no  value  in  this  respect.  If  we  take  further 
into  account  the  slight  light  strength  (as  measured  by  the  bolometer)  of  the 
iron  arc-light  as  compared  with  the  carbon  arc-light  or  with  sunlight,  the  first- 
named  may  be  practically  disregarded.  In  general,  the  microbicidal  action  of 
our  artificial  sources  of  light  is  much  less  than  is  often  assumed.  Vrohahly  it 
does  not  exist  at  all  when  the  micro-organisms  are  in  a  really  favourable 
nutritive  soil.  Pathogenic  bacteria,  which  in  any  case  grow  badly  in  our 
artificial    culture    media,    may    perhaps    when    in    the    latter    be    affected.     If 


4o6  RADIO-THERAPY 

ances  we  have  a  guarantee  for  the  utmost  possible  exactitude 
in  estimating,  on  the  one  hand,  the  bactericidal  energy  of  a 
source  of  light,  and,  on  the  other,  the  light-resisting  powers  of 
a  micro-organism.  It  appeared  that  concentrated  sunlight 
checked  the  growth  of  bacteria  after  one  minute,  and  caused 
death  in  5  to  7.  Concentrated  electric  arc-light  checks  growth 
of  bacteria  after  4-5  minutes,  and  kills  them  in  15  to  20.  Both 
the  arc-light  from  metal  electrodes  and  the  electric  spark  kill 
micro-organisms  after  a  few  seconds  (5  to  40). 

V.  Bie,  by  his  experiments,  was  able  to  prove  exactly  with 
which  parts  of  the  spectrum  the  bactericidal  action  of  light  is 
essentially  connected,  and  how  great  is  the  difference  between 
the  action  of  the  different  parts. 

Bie  made  his  experiments  with  the  bacillus  prodigio- 
sus  and  the  light  of  an  arc-lamp  of  35  amperes  and 
44-46  volts  (about  6,000  NK)  ;  the  light  was  concen- 
trated by  a  Fmsen  apparatus  and  fell  vertically  on  to 
the  culture.  As  light  filter  he  used  vessels  with  piano- 
parallel  glass  walls,  enclosing  a  layer  of  fluid  3  cm.  in 
thickness.     As  absorbing  media  he  used: 

1.  A  fresh  1%  sulphuric  acid  solution  of  quinine 
with  a  few  drops  of  sulphuric  acid,  which  allows  the 
passage  of  all  the  rays  but  the  ultra-violet; 

2.  A  5%  solution  of  sulphate  of  nickel,  which  was 
similar  in  action ; 

3.  A  i^%  solution  of  chromate  of  potassium,  let- 
ting through  red  to  green,   inclusive; 

4.  A  i^%  solution  of  bichromate  of  potassium,  let- 
ting through  red  to  yellow,  inclusive; 

5.  A  T%  solution  of  fuchsin,  letting  through  red 
alone. 

To  determine  the  light  of  intensity,  Bie  compared 
the  degree  of  blackening  of  spots  produced  during  given 
periods  of  illumination  on  aristo  paper. 
The  outcome  of  these  experiments  was  that  all  the  spectrum 


therefore  curative  action  has  been  proved,  it  can  only  be  referred  to  the  heat 
conditioned  by  light-absorption."  (Deutsche  med.  Wochenschr.  Nov.  21, 
1901,  No.  47.) 


PHOTOTHERAPY  407 

rays  (except  the  ultra-red,  which  were  not  examined),  in  an 
increasing  ratio  from  red  onwards,  check  bacterial  development. 
The  action  increases  with  the  ratio  of  refrangibility,  and  is  espe- 
cially marked  in  the  blue,  violet,  and  ultra-violet  spectrum. 
Red,  orange,  yellow  and  green  rays  also  act  injuriously  on 
bacterial  growth,  but  only  after  prolonged  illumination.  Pure 
red  light  even  did  not  produce  the  faintest  perceptible  retarda- 
tion of  growth  until  after  an  hour  and  a  half's  exposure. 

The  experiments  of  Sophiis  Bang,  Finsen's  most  competent 
colleague,  are  specially  remarkable,  the  care  with  which  they 
were  conducted  making  them  a  model  for  all  later  investiga- 
tions of  the  kind.  Bang  took  into  account  all  the  conditions 
to  be  noted  with  regard  to  light-action,  the  strength  of  light 
used,  the  distance  of  the  object  from  the  ray-source,  the  kind 
of  rays  passing  the  filters  and  the  amount  passing  through,  the 
percentage  of  light  penetrating  to  the  bacteria  (taking  into 
account  the  absorption  and  refraction  of  the  light  through  the 
containing  vessel  and  the  culture  medium).  The  experiments 
were  conducted  so  as  to  ensure  that  the  light-ray  should  meet 
with  as  few  obstacles  as  possible  on  its  passage  from  the  light 
source  to  the  object;  the  reflecting  planes  were  as  few  and  as 
simple,  and  the  absorption  and  refraction  as  slight,  as  possible; 
an  even  temperature  was  maintained,  and  measures  were 
adopted  for  varying  the  strength  of  the  light  according  to  the 
gradation  desired. 

Bang  used   for  these  experiments  an  apparatus  in 
which  the  bacteria  culture  was  spread  out  for  examina- 
tion in  the  thinnest  possible  layer,  e.  g.,  as  a  suspended 
drop  on  a  thin  quartz  plate.     This  quart/,  plate  is  used 
as  the  lid  of  a  "moist  chamber,"  this  chamber  again  is 
fixed  in  a  box  filled  with  water  of  an  even  temperature, 
kept  constantly  flowing  by  a  paddle-wheel.     The  light  is 
admitted  through  a  quartz  window  in  the  side  of  the 
box;  its  intensity  and  direction  of  Incidence  are  exactly 
estimated. 
In  this  manner,  Bang  came  to  the  conclusion  that  untler  the 
Influence  ftf  light  at  a  distance  of  28  cm.  from  an  electric  arc 
light  of  35  amperes  and  50  volts,  at  an  angle  of  45  to  the  axis 


<o8  RADIO-THERAPY 

of  the  carbon,  after  part  of  the  heat  rays  have  been  kept  back 
by  a  layer  of  water  (25  mm.  in  thickness)  between  quartz 
plates,  and  at  a  temperature  of  30°,  a  3  hours'  prodiglosus 
broth-culture  in  a  pendant  drop  is  sterilised  in  about  one  min- 
ute, a  10  to  15  hours'  culture  in  3  to  5  minutes.  The  light  acts 
more  quickly  at  45^  than  at  30",  sterilising  a  3  hours'  culture 
in  about  half  a  minute'" 

Thus,  then,  the  older  the  culture,  the  greater  its  power  of 
resistance  to  light  action;  and  further,  with  increase  of  tem- 
perature comes  increase  of  bactericidal  light-action.    . 

The  bactericidal  effects  of  sunlight,  according  to  Biicheur, 
Schickhardt,  Dieudonne,  Ujfclmann,  von  Pettenkofer,  Prans^ 
iiitz  and  others,  probably  plays  an  important  part  in  nature  in 
the  "self-cleansing"  of  rivers.  River  water,  contaminated  by 
sewage,  etc.,  after  having  flowed  for  some  distance,  becomes 
again,  so  far  as  bacteria  are  concerned,  what  it  was  before  the 
introduction  of  the  contaminating  matter.  No  doubt,  however, 
this  is  partly  the  result  of  the  great  dilution  of  the  foul  matter, 
the  deposit  of  floating  particles  as  sediment  and  the  absorption 
or  decomposition  of  substances  by  living  creatures  (plants  or 
animals).  JVittlin  showed  that  street  dust  is  disinfected  in  a 
high  degree  by  exposure  to  direct  sunlight.  Von  Esmarch 
tested  the  bactericidal  action  of  direct  sunlight  on  germ-contain- 
ing clothes,  bedclothes,  etc.,  and  found  that  the  action  is  con- 
fined to  the  uppermost  layers  of  the  objects  and  does  not  pene- 
trate at  all  to  the  interior. 

It  has  also  been  maintained  that  the  receptivity  of  an  organ- 
ism to  living  bacteria  and  to  bacterial  poisons  is  lessened  by 
exposure  to  light  (Kondratjezv,^)  (Gebhard,-)  {Joussct^)  ). 
According  to  Bceder,'^)  however,  who  investigated  this  point 
minutely,  this  is  open  to  question. 

Besides  its  action,  in  checking  the  development  and  growth 
of  bacteria,  we  know  further  that  light  influences  their  move- 


^)  Quoted  by  Divorctzkv,  Zeitschr.  f.  diaetetische  u.  phys.  Therapie,  Vol. 

V,  bk.  3. 

*)  Die  Heilkraft  des  Lichtes,  Leipzig,  1898. 

')  La  Semaine  medicale,  1900,  45. 

*)  Arbeiten  aus  dem  kaiserl.  Gesundheitsamts,  1900,  Vol.  XVH,  bk.  i. 


PHOTOTHERAPY  409 

ments.  According  to  JJ'inogradsky;)  and  Bcijcr'mck,-)  sul- 
phur-bacteria and  the  chromogenic  bacteria  always  collect  at 
the  lightest  spot;  they  are  thus  positively  phototaxic. 


3.   The  Effect  of  Light  on  Higher  Organisms. 
(Animals,  including  Man.) 

^  S^-  I"  animals,  as  in  plants,  light  exercises  a  stimulating 
'nfluence  on  the  functions  of  tissue-elements  and  organs;  the 
,'nergy  infused  into  the  body  by  light  is  transmuted  into  stimu- 
lus, quickening  and  heightening  all  the  vital  processes.  As  a 
■stimulus,  light  either  influences  directly  the  protoplasm  of  the 
irradiated  cells,  or  it  brings  about  by  indirect  means  (through 
the  sense-organs  and  nerves)  certain  functions  on  the  part  of 
given  organs. 

It  has  long  been  recognised  as  a  fact  that  the  development 
of  many  animals  is  dependent  on  light;  without  light  develop- 
ment proceeds  slowly  or  is  suspended  altogether.  JVilUam 
Edwards^)  observed  that  frog-spawn  in  an  opaque  glass  died, 
whilst  spawn  in  a  transparent  glass  became  duly  developed. 
The  development  of  tadpoles  then  proceeds  more  slowly  in  the 
dark.  Schnetzler's  *)  experiments  proved  that  white  light  is 
more  favourable  than  green  to  such  development.  E.  Young  ^) 
showed  that  violet  light  helps  on  the  development  of  the  embryo 
or  rana,  salmo  and  lymenea,  whilst  darkness  or  other  parts  of 
the  spectrum  hinder  or  disturb  it.  Beclard^')  found  that  flies' 
eggs  develop  more  quickly  under  blue  and  violet  glass  than 
under  red,  yellow,  green  or  white.  Guarinoni')  believes  his 
experiments  to  prove  that  violet  light  acts  favourably  on  silk- 


')  Zur  Morphologic  unci   Physiologic   dcr   Sch\vofe'Il)aktcricn. 

*)  Centralblatt  f.  Bakteriologie,  Vol.  XIV,  p.  844. 

*)  De  I'influence  dcs  agents  physiques  sur  la  vie,   Paris,   1824. 

*)  Archives  des  sc.  physiques  et  naturelles,  1874,  Vol.  LI. 

")  Compt.  rend.,  Vol.  LXXXVII. 

•)  Compt.  rend.   1858. 

^)  Quoted  by  Edcr,  J.  M.,  Ucber  die  chcm.  WirkniiKi'ii  d.   farb.  Liohtcs, 
Vienna,   1879. 


410  RADIO-THERAPY 

worms.  Godnew  ^)  noticed  that  maggots  are  much  more  quickly 
developed  in  pieces  of  meat  exposed  to  the  light  than  in  meat 
kept  in  the  dark.  Loeb  ^)  made  a  study  of  the  action  of  light  on 
polypi  and  found  that  growth  is  not  affected  equally  by  all  the 
rays,  but  that  only  the  more  refrangible  (f.  e.,  blue)  rays  fur- 
ther growth,  whilst  the  red  ones  have  the  same  effect  as  dark- 
ness. Light  exercises  a  powerful  influence  also  on  the  growth 
of  the  higher  animals  at  a  later  stage.  Poey  ^')  believes  he  has 
proved  that  sucking  pigs  and  calves  do  better  in  violet  light  than 
in  white  (  ?) .  Young  rabbits  do  not  get  on  at  all  in  the  dark. 
Every  farmer  knows  that  it  is  a  universal  rule  that  beasts  flour- 
ish better  in  bright,  sunny  sheds  than  in  dark  ones.  And  the 
healthy  development  of  young  children,  as  is  well  known, 
depends  in  large  measure  on  light. 

Not  only  the  general  growth,  however,  is  affected  by  vary- 
ing supply  of  light,  but  also  the  development  of  individual 
organs  and  parts  of  organs.  It  is  a  well-known  fact  that  a 
large  number  of  pigment-containing  cells  are  found  in  the  light 
than  the  dark  (ephelids).  Berthold  *)  and  Finsen^^)  have 
shown  that  epidermal  growth  (as  of  nails  and  hair)  is 
favoured  by  light  and  hindered  by  darkness.  Both  patients 
and  nurses  in  Finseji's  clinic  acquired  a  thicker  growth  of  hair 
on  those  parts  which  were  exposed  repeatedly  and  for  a  long 
time  to  the  powerful  electric  ray.  It  has  been  proved  that  with 
amphibia  and  fishes  limbs  that  have  been  broken  off  grew  again 
more  rapidly  in  the  light  than  in  the  dark. 

The  stimulating  effects  of  light  on  transformation  of  form 
and  transformation  of  energy,  especially  on  the  phenomena  of 
movement,  have  been  proved  by  many  interesting  observations. 

The  arrangement  of  the  protoplasm  of  amoeboid  cells 
[(amoeboe,  rhizopods,  infusoria)  is  noticeably  changed  by  expos- 
ure for  any  length  of  time  to  light  or  darkness.  The  plas- 
modia  of  asthalium,  which  in  the  dark  have  crawled  to  the  sur- 


')  Kasan'^che:  Dissert.,  1882. 

')  Pnueger's  Archiv,  Vol.  LXIII. 

■■')  Compt.  rend.,  1871,  Vol.  LXXIII. 

*)  Mueller's  Archiv.  f.  Anatomic  unci  Physiologie,   1850,  p.   158. 

'")  riTitthcilgn.  aus  Finscn's  med.  Lichtinst.,  Vol.  I,  p.  118. 


PHO  rO  THERAPY  41 1 

face  of  the  tan  withdraw  again  to  the  depths  in  a  bright  hght. 
In  the  hght  they  develop  short,  compressed  projections;  in  the 
dark  long,  thin,  narrow  processes.  Here  then  light  seems  to 
act  in  the  same  way  as  artificial  irritants. 

It  is  well  known  that  change  of  light  causes  changes  of 
form  in  the  contractile  pigment-cells,  in  the  skin  of  many  fishes, 
amphibia,  and  reptiles,  thereby  producing  change  of  colour  in 
the  animals.  Under  a  bright  light,  e.  g.,  the  black  pigment- 
cells  of  the  frog's  skin,  which  in  the  dark  have  wide-spreading 
ramifications,  contract  gradually  into  little  balls,  making  the 
skin  appear  lighter.  Under  sudden  illumination  pelomyxa  pal- 
ustris  contracts  in  a  few  seconds  into  a  ball,  after  the  granule- 
streaming  has  ceased.  If  the  light  is  maintained,  only  weak, 
slow  movements  are  again  observable.  When  the  darkness  is 
dissipated,  by  the  gradual  coming  on  of  daylight,  there  is  no 
irritant  effect  {Engelmanu  ^).  To  Engelmann  we  owe  also  the 
discovery  of  bacterium  photo-metricum,  which  is  extraordinar- 
ily sensitive  to  light  stimuli.  So  long  as  it  is  exposed  to  light, 
it  propels  itself  swiftly  about  in  the  drop  of  water  by  the  aid  of 
the  scourge-like  thread  which  is  found  at  the  ends  of  each  bac- 
terial body.  When  it  is  brought  into  the  dark  the  movement 
of  the  thread  gradually  ceases  and  the  bacterium  remains 
motionless,  to  be  stimulated  again,  however,  to  fresh  movement 
under  renewed  light-action.  By  means  of  a  spectrum  apparatus 
Engelmann  was  able  to  fix  on  the  orange  and  ultra-red  rays, 
as  the  specially  active  factors  in  this  bacterial  movement"). 
Light  has  also  a  very  powerful  influence,  particularly  in  regard 
to  the  direction,  on  the  ciliary  movement  of  the  green  swarm- 
spores  of  the  lower  plants  and  flagellates. 

According  to  Uskof,  the  ciliary  movement  of  the  epithelium 
of  the  oesophagus  is  equally  swift  in  red  and  in  violet  light,  but 
it  is  suspended  if  red  light  is  substituted  for  previously  acting 
violet. 

Even  among  the  ciliary  infusoria,  which  are  not  generally 
sensitive  to  light,   isolated  specimens  are  found  whose  ciliary 


')   Archiv.   f.  d.  ges.    Physiologic,   XTX,  p.   i,  and   ITaiuIl)iu-Ii  dor   Physi- 
ologic, Vol.   I,  p.  370. 

")   I'flucgcr's   Archiv.,   Vol.   XXX. 


412  RADIO-THERAPY 

movements  are  stimulated  by  light.  Verworn  ^)  observed  that 
pleuronema  chrysalis,  which  when  undisturbed  lies  motionless  in 
the  water,  makes  violent  movements  when  suddenly  exposed 
to  light,  but  only  after  a  period  of  latent  irritation  (one  to  two 
seconds),  not  at  once  when  the  light  falls  on  it.  Verworn 
proved  that  this  leaping  movement  is  not  the  result  of  possible 
heat-action  of  the  light,  but  is  due  in  largest  measure  to  the 
action  of  the  blue  and  violet  rays. 

It  is  true  the  same  effect  can  be  produced  with  Intense  (con- 
centrated)  heat-rays. 

Uskof  ^)  made  a  study  of  the  behaviour  of  the  protoplasm 
of  blood  cells.  The  w^hlte  corpuscles  of  frog's  blood  showed 
more  and  longer  processes  In  red  light  than  in  violet;  further 
they  were  in  the  former  spread  out,  for  the  most  part,  in  the 
form  of  hardly  visible  discs.  According  to  Hermann,^)  on  the 
other  hand,  leucocytes  are  not  sensitive  to  light,  whilst  red  cor- 
puscles show  distinct  changes  of  shape.  Finsen  observed*)  that 
the  red  corpuscles  In  tadpoles'  blood  changed  shape  under  the 
influence    of   sunlight;    they   contracted   and   became    rounder. 

According  to  Auerbach,  light  acts  as  a  powerful  inducer  of 
contractions  on  the  protoplasm  of  frog  spawn.  Finsen/') 
too,  noticed  In  his  experiments  with  frog-spawn  and  salamander 
germs,  that  light  possesses  In  a  high  degree  the  power  of  induc- 
ing movements  of  the  germ,  and  that  this  power  Is  present  to  a 
quite  special  extent  In  the  blue-violet  rays.  Daphnia  pulex  shows 
with  increasing  strength  of  hght  increased  precision  and  swift- 
ness of  motion. 

Red  light  is  most  favourable  to  the  movements  of  amoeboe. 
Both  the  violet  rays  and  white  light  have  an  Impeding  effect. 
{Harrington  and  Learning.) 

Experiments  on  the  Influence  of  light  rays  on  the  move- 
ments of  older  animals  have  given  similar  results. 


')   Quoted    from    Vcrzvom,    Allgemein.    Physiologic   u.    psycho-physiolog. 
Protistenstudien,  Jena,  1889. 

^)  Centralbl.  f.  d.  med.  Wissensch.,  1879,  No.  25. 

')  Quoted  in  Strebel,  p.  6. 

*)   Ueber  die  Bedeutung  d.  chem.  Strahlcn,  Leipzig,   1879. 

*)   Centralbl.   f.   d.  Wissensch.,   1870,   No.   23. 


PHOTOTHERAPY  413 

To  this  class  belongs  the  action  of  light  in  directing  the 
movements  of  the  more  highly  organised  animals;  it  is  not 
always  easy,  however,  to  determine  the  extent  of  this  because 
of  the  large  part  played  also  by  the  organs  of  sense  and  the 
nervous  system.  The  experiments  of  Lotb^)  and  of  Parker 
and  Burnett  -)  have  shown  that,  just  as  with  plants,  so  also  with 
many  animals,  light  has  an  influence  on  the  direction  of  their 
movements.  Many  sightless  animals  even  show  signs  of  helio- 
tropism. 

Light  often  exercises  over  animal,  as  well  as  vegetable 
organisms,  the  same  kind  of  Irresistibly  compelling  power  that  a 
magnet  does  on  iron;  they  are  forced  to  turn  towards  or  aw^ay 
from  the  source  of  light. 

Thus  a  gnat  is  always  attracted  by  an  artificial  light,  in 
whose  flame  it  will  singe  its  wings  and  lose  its  life.  Blind  frogs 
always  turn  their  heads  towards  the  source  of  light  and  place 
themselves  so  that  its  rays  may  fall  symmetrically  on  both  sides 
of  their  bodies  {IVwedensky  '^)) .  If  put  in  a  box,  of  which 
one-half  is  illuminated,  the  other  dark,  they  will,  according  to 
Bert*)  always  try  to  get  to  the  bright  part.  It  is  well  known, 
however,  that  whilst  some  animals  love  the  light  and  always 
make  for  sunlight,  there  are  others  which  dread  light  and  live 
in  the  dark. 

Many  animals,  c.  g.,  ants  and  bees,  are  able  to  distinguish 
colour.  Earwigs,  wood-lice,  carabidde  (Fiiisrtr')  ) ,  even  eye- 
less creatures,  like  the  earthworm  {Grabir'') ),  and  blind  ones, 
like  the  triton,  are  peculiarly  sensitive  to  the  short-waved  (blue, 
violet)  rays  of  light,  taking  shelter  in  darkness  or  the  longer- 
waved  (red)   rays. 

Other  creatures  again,  e.  g.,  butterflies,  prefer  the  blue  and 
violet  rays. 


')  Der  HcliotrnpisiTiiis  dcr  Thicrc,  etc.,  \Viirzl)urR.   1800. 

^)  Wirkung  auf  F'lanaricn,  Amer.  Journal  of  Physiol.,  IV,  8.  p.  273. 

')  Bull,  de  I'Acad.  dcs  Sc,  a  Peter.'^bourg,   1879. 

*)  Revue  Scientif..   1878,  42. 

*)  Ueber  die  Bcdcutung  dcr  clu-ni..  Strahlcn.  T.cipzip:,  p.  58. 

*)  Sitzung^bfT.  dcr  kaiscrl.  Akad.  der  Wissensch.,  VVicn,  math.-  naturw. 
CI.  1883.  Vol.  LXXXVII,  Part  I,  p.  201. 


414  RADIO-THERAPY 

Cohen  and  Strassbiirger  proved  that  In  general  the  short- 
waved  rays  have  a  stonger  phototaxic  effect  than  the  long- 
waved,  which,  if  not  present  in  a  too  high  degree  of  intensity, 
have  the  same  action  as  complete  darkness. 

The  course  of  phototaxic  phenomena,  however,  often 
depends  on  other  circumstances.  Light  affects  paramoecium  bur- 
saria  only  when  the  supply  of  oxygen  is  insufficient;  with  suffi- 
cient oxygen  the  light  stimulus  is  ineffective. 

With  larv£E  of  polygordius,  phototaxic  phenomena  appear 
only  if  the  temperature  is  raised  at  the  same  time. 

Many  animals  react  chiefly  to  fluctuations  in  the  intensity  of 
the  light. 

With  reference  to  the  action  of  light  on  given  tissue-ele- 
ments, a  close  study  has  been  made  of  its  effect  on  muscles. 

We  do  not  at  present  know  that  light  has  any  influence  on 
the  movements  of  striped  muscular  fibre. 

Researches  have  been  made  into  the  action  of  light  in  stim- 
ulating unstriped  muscular  fibre  by  Fr.  Arnold,  Reinhardt, 
Budge,  Brown-Sequard  and  Heinrich  Mueller^)  and 
Steinach') .  The  incidence  of  light  (without  heat)  causes 
the  iris  to  contract  in  the  extracted  eye  of  amphibia  or  fishes, 
that  is,  independently  of  the  central  nerve-system,  and  this 
though  the  retina  may  have  been  removed  and  the  eye  extracted 
for  a  long  time  (i6  days  from  an  eel  in  winter!). 

Brozvn-Seqnard  regards  this  phenomenon  as  direct  muscle- 
irritation  by  light.  Harless,^)  with  human  corpses,  too 
observed  for  a  period  of  30  hours  after  death  distinct  con- 
traction of  the  pupil  of  the  eye  exposed  to  light,  as  compared 
with  that  of  the  closed  eye. 

De  Parv'ille  (quoted  by  Buedingen)  claims  to  have  proved 
the  red  end  of  the  spectrum  to  be  nerve-irritating,  and  the 
reverse  end  (green,  blue  and  violet)  to  be  nerve-soothing. 
Buedingen,  however,  was  unable  to  confirm  this. 

Th.  Buedingen,^)  in  order  to  solve  the  question  whether  light 

^)  Wiirzburger  naturw.  Zeitschr.,   1861,  II,  p.   133. 

^)  PnUger's  Arch.,  Vol.  LII. 

')  Abhdlgn.  d.  bayr.  Akad..  1848,  V,  p.  490. 

*)  Zeitschr.  f.  diaet.  und  physik.  Therapie,  Vol.  VI,  bk.  5,  p.  272. 


PHO  TO  THERAPY  4 1 5 

acts  on  muscle  directly,  or  through  the  motor  nerves,  on  a  nerve- 
muscle  preparation,  and  further,  whether  reflex  movements  can 
be  set  up  by  irradiation  of  the  skin,  made  experiments  with  ani- 
mals whose  cerebrum  had  been  removed  and  the  nerve  connec- 
tion between  brain  and  spinal  cord  severed.  These  experiments 
showed  that  light,  as  applied  In  the  form  of  sudden  transition 
from  darkness  to  a  blue  or  red  light  in  concentrated  form,  had 
no  direct  influence  on  the  nerve-muscle  preparations  made  from 
frogs,  and  further,  that  it  was  not  able  to  modify  contractions 
caused  by  other  stimuli.  Neither  did  the  experiments,  as  to  the 
possible  Influence  of  concentrated  red  and  blue  arc-light,  on  the 
reflex  Irritability  of  animals  whose  cerebra  had  been  removed 
show  the  slightest  trace  of  such  action.  Buedingen  concludes 
that  the  reflex  Irritability  of  the  spinal  cord  is  not  influenced  by 
light  rays  falling  on  the  skin. 

Besides  the  muscle-cells,  there  is  a  series  of  other  cells  which 
react  to  the  stimulus  of  powerful  light-Irradiation.  This  is 
proved  by  the  phenomena  of  erythema  solare,  dermatitis  photo- 
electrica,  xeroderma  pigmentosum,  hydro,  and  summer  erup- 
tions, pellagra  and  the  various  pigment  anomalies,  due  to  the 
Influence  of  light. 

Light  produces  obvious  effects  on  the  skin  of  the  higher 
animals.  According  to  Unna,^)  the  skin  becomes  coarser  and 
harder  in  parts  exposed  to  the  light,  because  under  the  influence 
of  light  protoplasm  becomes  reduced  to  keratine.  Moeller'-) 
was  able  to  prove,  experimentally  and  microscopically  (p.  432), 
that  light  sets  up  hyperplasia  of  the  epidermis  and  an  abnormal 
horning-process. 

The  changes  in  the  skin,  known  as  erythema  or  eczema 
solare  s.  photoelectricum,  consisting  in  the  diffused  production 
of  redness,  small  blisters  and  pustules,  which  may  in  severe 
cases  lead  to  leuco-sero-fibrlnous  inflammation  of  the  whole 
skin-covering,  are  regarded  as  disturbances  of  the  circulation. 
We  cannot  for  the  present  discuss  the  question  whether  these  . 
phases  of  hyperaemla   and   the   conditions  which   they   induce. 


')   Monatsh.   f.  prakt.   Dcrmatologic.  1885,  IV,  p.  284. 

^)   Der    Einfluss    dos    Lichtes    auf    die    Haut.    Bihliotli.    iiied.,    Stuttgart, 
1900,  p.  18. 


41 6  RADIO-THERAPY 

which  arise  also  in  other  organs  under  strong  light,  e.  g.,  the 
conjunctiva,  the  nose,  gills  (in  proteus,  Rusconi,'^)  are  to  be 
regarded  as  due  to  action  on  the  vascular  nerves,  or  as  being 
induced  by  primary  injury  (degeneration)  of  the  tissue  cells. 
It  has  certainly  been  proved,  by  various  histological  experiments 
{Ogfieff,  Moeller,  Glebowssky)  (see  later)  that  light  produces 
local  pathological  changes  in  the  body-cells  which  are  subjected 
to  powerful  rays. 

It  is  well  known  that  it  is  often  difficult  to  get  workmen  in 
factories  where  the  work  is  carried  on  in  strong  arc-light, 
because  of  the  injuries  caused  by  light  {Maklakow). 

The  phenomena  of  this  reaction  on  the  skin  are  as  follows: 
the  skin  becomes  a  bright  to  copper  red,  swells,  and  is  burning 
and  painful.  These  signs  are  masked  in  consequence  of  prolif- 
erative processes  in  the  horny  layer.  After  more  powerful 
light  action,  larger  or  smaller  blisters  are  formed,  with  ecchy- 
mosis,  and  even  more  or  less  deep-seated  necrosis  of  the  tissues. 
Very  marked  signs  of  ill-health  may  thus  be  produced.  After  a 
few  days  the  skin  becomes  less  red,  and  increasing  pigmentation 
ensues;  the  swelling  goes  down,  the  blisters  dry  up,  the  epider- 
mis peels  off,  at  first  in  larger  flakes,  as  after  scarlet- fever,  and 
later  in  small  scales.  Makalkow-)  and  JFidmark")  drew 
attention  to  an  important  fact,  in  connection  with  this  reaction, 
viz.,  that  the  changes  in  the  skin  do  not  appear  at  once,  imme* 
diately  after  the  action  of  the  light,  being  in  this  respect  a  con- 
trast to  changes  brought  about  by  heat-rays,  which  are  visible  at 
once,  but  die  away  quickly. 

Light  erythema,  on  the  other  hand,  as  well  as  the  Roentgen 
reaction,  appears  only  after  being  latent  for  a  longer  or  shorter 
time;  the  period  of  its  duration,  in  which  it  reaches  its  height, 
is  prolonged  in  proportion  to  the  intensity  of  the  light  action, 
and  it  dies  away  slowly  with  desquamation  and  absorption  of 
pigment. 

Maklakow  tried  to  determine  the  period  of  latency  after  the 

')   Cit.  bei  Raiim,  p.  338. 

^)   Archives  d'ophthalmologie,  1889,  Vol.  IX,  p.  97. 

')  Hygiea,  Festband,  No.  3,,  1889.  —  Beitrage  zur  Ophthalmologie,  Leip- 
zig, 1881,  p.  438. 


PHOTOTHERAPY  417 

use  of  a  powerful  arc-light.  The  effect  of  an  irradiation,  last- 
ing only  15  seconds,  was  not  seen  till  after  10  hours.  A  part 
of  the  skin,  subjected  to  light  action  for  one  minute,  showed  dis- 
tinct circumscribed  hypera^sthesia  after  half  an  hour,  redness  . 
shelving  itself  only  after  2^:4  hours.  Regions  of  the  skin 
exposed  to  the  light  for  3}  minutes  became  red  in  11  minutes, 
and  parts  irradiated  for  5;4  minutes  showed  erythema,  after  3 
minutes.  These  results  were  confirmeci  by  Flnsen  ^)  and  iMoel- 
ler'-)  after  accurate  experimental  research. 

If  now  we  compare  these  facts,  with  the  effects  produced  on 
the  skin  by  heat-rays  and  Roentgen-rays,  we  may  deduce  the 
following  laws  as  to  the  speed  with  which  the  reaction  shows 
itself  and  the  length  of  its  duration : 

/.  The  duration  of  the  period  of  latency  is  in  inverse  ratio 
to  the  nave-length  of  the  active-rays;  in  like  manner  the  effect 
lasts  longer  in  proportion  as  the  wave-length  of  the  active  rays 
becomes  shorter. 

2.  The  greater  the  intensity  of  the  light,  the  earlier  does 
reaction  shozv  itself  and  the  longer  does  it  last.  If  the  intensity 
Is  less,  reaction  shows  itself  later  and  lasts  for  a  shorter  time. 

Fins  en  and  Moeller  proved  by  experiment  a  peculiarity  of 
light  reaction  precisely  corresponding  to  that  observed  by  the 
author  with  Roentgen-ray  reaction").  Skin,  which  has  been 
exposed  to  powerful  influence  from  chemical  {blue,  ultra-violet) 
rays,  retains  for  a  long  time  {months  and  years  after  the  first 
light-erythema  has  disappeared)  a  peculiar  predisposition  to 
react  remarkably  quickly  {by  reddening)  to  mechanical,  chemi- 
cal and  thermal  stimuli-  and  also  to  internal  influences  {psychical 
stimulus,  etc.) . 

The  relation  of  the  skin  pigment  to  light  is  very  interesting. 

We  have  above  (p.  410)  already  referred  to  the  part 
played  by  light,  in  causing  colour-change  in  animals.  There 
are  in  the  skin  of  very  many  animals  (also  in  other  organs,  e.  g., 
in  the  iris  of  amphibia  and  fishes)   pigment-cells  or  chromato- 


^)   Mittheil.  aus  Piiiscn's  med.  Lichtinst.,  1900.  I.  Loipzip,  Vogcl. 
^)   Der  Einfluss'dcs  Lichtcs  auf  die  Haut,  Stuttgart. 

*)   Cf.  die  physiolog.  Wirknngcn  dor  Polcntladungen,  etc.    Sitznngsber.  d. 
kaiserl.  Akad.  d.  Wissensch.,  matli.-natiirw.  CI.,  Bd.  CIX,  Abtli.  Ill,  p.  644. 


41 8  RADIO-THERAPY 

Inheres,  the  protoplasm  of  which,  on  being  irritated  by  light, 
extends  or  withdraws  processes,  thereby  distributing  the  pig- 
ment over  a  larger  or  smaller  space.  In  many  parts  {e.  g.,  the 
iris)  these  chromatophores  may  also  be  regarded  as  pigmented, 
unstriped  muscle-fibres,  or  as  cells  to  the  periphery,  of  which 
muscle-fibres  attach  themselves,  which  react  to  light  stimulus  by 
contraction. 

Bruccke,  who  has  made  the  closest  study  of  colour-change, 
in  the  chameleon,  showed  that  the  movement  of  the  chromato- 
phores is  dependent  on  the  central  nervous-system.  Darkness 
acts  on  the  skin  of  this  animal  as  a  stimulus,  whilst  daylight, 
even  sunshine,  reduces  the  pigment-cells  to  a  passive  state. 
When  these  creatures  are  brought  out  into  the  sunlight  they 
become  dark  (projecting  the  elongations  of  their  pigment-cells 
to  the  surface  of  the  body)  ;  when  they  are  taken  into  the  dark 
they  become  pale  in  colour  (the  creature  drawing  back  the  dark 
elongations  of  Its  pigment-cells,  so  that  they  are  covered  by  the 
light-coloured  pigment  In  the  upper  layers  of  the  cuticle). 

It  Is  clear,  from  the  varying  behaviour  of  chromato- 
phores under  irritation    (strychnine-poisoning,   rubbing 
with  turpentine,  strokes  of  a  magnetic  electromotor)  and 
under    paralysation     (by    cutting    through    the    main- 
nerves)    that  we  are  right  in  taking  the   condition  in 
which  the  cells  extend  their  processes  as  being  the  pas- 
sive condition  of  rest,  and  the  condition  In  which  they 
draw  in  the  processes  as  the  active  condition  of  irrita- 
bility. 
The  action  of  light  on  the  skin  is  local;  for  according  to 
Briiecke  If  a  band  of  tin-foil  is  put  round  a  chameleon  and  the 
creature  placed  in  the  sun,  there  will  be  a  light-coloured  strip 
under  the  tin-foil,  whilst  the   rest  of  the  body  will  be  dark. 
Bruecke  proved  that  this  is  really  light  action,  and  not  the  action 
of  radiant  heat.     P.  Bert^)    found  that  It  is  the  blue  constit- 
uents of  light,  and  not  the  red  and  yellow,  which  affect  the 
chromatophores  and  to  which  we  must  ascribe  the  effects  dis- 
cussed. 


^)  Hoppc-Scylcr,  Physiol.   Chcmie,   1881,  p.  25. 


PHOTOTHERAPY  419 

As  with  the  chameleon,  so  with  other  animals,  it  has  been 
proved  that  the  protoplasmic  movement  of  the  chromatophores 
caused  by  light  takes  place  through  the  central  nervous  system. 
The  experiments  of  Ehrmaiiu,  who  observed  in  frogs  the  direct 
passage  of  nerve  filaments  into  the  pigment  cells,  make  it  prob- 
able that  the  chromatophores  are  connected  with  the  central 
nerve  organ. 

Turbots,  which  had  had  the  sympathetic  nerve  cut  through, 
became  dark  in  that  part  of  the  body  whose  nerves  had  their 
origin  behind  the  incision. 

Blinded  fishes  become  dark  in  colour  through  the  spreading 
out  of  the  pigment  cells. 

Briieckc  surmises  that  there  is  a  reflex  action  starting  from 
the  v^isual  nerv^e,  and  that  a  stimulus  of  the  optic  nerve  passes 
on  to  the  central  organ,  a  stimulus  which  causes  the  chromato- 
phores to  contract;  so  that  when  this  stimulus  is  wanting,  they 
permanently  cover  a  larger  space  ^).  According  to  JVittich') 
and  E.  Dii  Bois-Reymond,^)  the  colour  of  frogs  and  the  sheaf- 
fish  is  also  dependent  on  light,  these  creatures  being  black  in  the 
dark  and  turning  light-coloured  again  under  the  influence  of 
light. 

Exner  drew  attention  to  the  movements  of  pigment  in  the 
eyes  of  insects  as  a  result  of  light. 

The  behaviour  of  these  creatures  with  regard  to  light 
becomes  intelligible  when  we  consider  that  pigment,  as  we  shall 
see  directly,,  is  a  natural  protection  against  the  action  of  light. 
Creatures  avail  themselves  of  this  protection  in  proportion  as 
the  light-irritation  becomes  more  or  less  unpleasant  to  them. 

We  must  distinguish  this  passing  and  occasional  reaction  of 
the  chromatophores  to  light  irritation  from  the  more  or  less  per- 
sisting pigmentation,  observable  in  both  men  and  animals  in 
regions  exposed  to  light.  According  to  Ehrmann,  where  the 
sun's  rays  fall  on  a  skin  in  which  melanoblasts  are  present  (/.  e., 
cells    which    produce    melanin,    a    melanotic    brown    pigment. 


')  Quoted  from  Brucckc,  Vorles.  uchcr  Physiologic,  1S85,  Vol.  I. 
^)  Mueller's  Archiv,   1854. 

')  Uritersuch.  zur  Naturlehre  dcs  Menschcn  u,  dcr  Thicrc,  vun  Mok- 
scott,  1858,  Bd.  V. 


420  RADIO-THERAPY 

formed,  only  by  cells,  not  in  the  interspaces)  melanin  is 
developed  there  from  the  more  abundant  nutriment  received, 
and  under  the  stimulus  to  the  cells  of  the  light  rays.  Thence 
results  the  sepia-brown  colouring  of  the  skin,  lasting  some- 
times for  years. 

There  is  a  different  reason  for  the  deep  but  evanescent  brown 
of  the  skin  often  to  be  seen,  e.  g.,  in  tourists  after  a  glacier 
excursion,  as  the  remains  of  erythema  solare  s.  photoelectricum 
after  a  single  but  intense  exposure  to  light.  In  this  case  the 
strong  light  produces  marked  hyperaemia  of  the  skin;  blood- 
plasm,  in  which  haemoglobin  is  dissolved,  finds  its  way  out 
freely  through  the  walls  of  the  capillaries.  In  a  short  time  the 
haemoglobin  is  deposited  in  the  interstices  of  the  tissues  as 
golden-yellow  hasmosiderin,  causing  the  brownish-yellow  colour 
of  the  skin,  which  only  disappears  in  a  few  weeks  after  this  blood 
pigment  has  been  reabsorbed.^)  The  pigment  may  also  be 
developed  from  the  red  corpuscles  directly;  they  may  pass  by 
diapedesis  out  of  the  walls  of  the  blood  vessels  and  shrivel  up 
into  pigment  corpuscles. 

As  already  observed,  pigment  is  the  skin's  protective  organ 
against  light  rays.  One  evidence  of  this  is  that  races  of  men 
exposed  always  to  strong  insolation,  are,  like  animals,  darker  in 
colour  at  those  parts  of  the  body  exposed  to  the  light.  JF e ti- 
ding-)  observed  the  remarkable  fact  that  cattle  and  sheep  fed 
on  buckwheat  broke  out  in  blisters,  if  they  were  light  in  colour 
or  were  exposed  to  sunlight.  Beasts  kept  in  the  dark  remained 
healthy.  Parti-coloured  beasts  showed  sickness  only  in  the 
light  parts,  the  dark  parts  remaining  unchanged.  Wedding 
smeared  part  of  one  cow  with  tar;  the  eruption  appeared  only  on 
the  untarred  parts  of  the  skin. 

Last  summer  the  author  came,  by  chance,  on  a  cor- 
roborating instance.  A  dark-complexioned  man,  who 
had  for  many  years  had  vitiligo  patches  on  the  body  and 
face,  after  a  long  walk  over  the  Grossglockner  glacier, 
developed    violent    inflammation     (erythema)     in    the 


^)  .9.  Ehrmann,  Wiener  med.  Wochenschr.,  1901,  No.  30. 

^)  Verhandlungen  der  Berliner  Gesellschaft  fiir  Anthropologie,  1888,  p.  57. 


PHOTOTHERAPY  421 

neighbourhood  of  the  white  patches  on  the  face,  but 

in  these  regions  alone.     The  rest  of  the  skin  was  quite 

unaffected. 

Fbiscn    proved,    by    a  very    Interesting    experiment,    that 

acquired  pigmentation  may  also  have  protective  power  against 

the  Injurious  action  of  light  rays. 

Finsen   painted  a   ring   round   his   arm   with   black 
paint  and  then  exposed  the  arm  for  3   hours  to  very 
strong  sunlight,   after  which  the  paint   was   removed. 
The  skin  after  a  few  hours  seemed  quite  white  and  nor- 
mal, showing  only  some  redness  at  the  edges  of  the  belt 
of  paint.        A   few  hours  later  violent  erythema  was 
developed  In  the  exposed  part,  but  in  the  painted  belt 
the    skin    was   white    as   before.      The   boundary    line 
between  the  affected  and  the  normal  parts  of  the  skin 
was    extraordinarily    sharp    and    showed    precisely    the 
same  small  irregularities  as  the  edges  of  the  black  belt. 
After  the  erythema  had  passed  off  the  skin  was  a  good 
deal  discoloured.     Now  F'uiscn  again  exposed  the  arm 
to  sunlight,  without  blackening  any  part;  the  result  was 
precisely  the  reverse,  the  white  band  was  attacked  by 
erythema,  the  neighbouring  parts  remained  unchanged. 
Tiglit  crytlicnia  and  light  pigniifilatiou  arc  due  to  the  ultra 
violet  rays.    Charcot  ^)  already  surmised  that  it  Is  the  so-called 
chemical  rays  that  produce  erythema  photoelectricum.    Veiel,-) 
too,  showed  as  early  as  1887  that  the  chemical  rays  of  sunlight 
produce  a  peculiar  affection  of  the  skin,  consisting  In  swelling 
of  the   face  and  a  red  eruption,   like  nettlerash.      He  recom- 
mended the  wearing  of  a  red  veil  to  absorb  the  chemical  rays, 
and  this  simple  remedy  acted  very  well.    Unna,^)  too,  and  C. 
Berliner*)  also  JTolters'')  pointed  to  the  chemical  (violet  and 
ultra-violet)  light-rays  as  the  cause  of  erythema  solare,  of  xero- 
derma pigmentosum,  and  of  Hutchinson's  summer-eruption,  and 


')  Compt.  rend.   Soc.  biolog.,   1859,  p.  63. 

^)  Vierteljahrcsschr.   f.   Derm.   u.    Syph.  Jahrg.,   1887,  p.   277. 

')  Monatsh.  f.  praktische  Dermatologic,  1885,  Vol.  IV,  p.  277. 

*)  Ibid.  1890,  Vol.  XI.  Nos.   10.  11. 

°)  Erganzungsli.  z.  Arch.  f.  Dcrmat.  u.   Syph.,   1892.  ]>.   1S7. 


422  RADIO-THERAPY 

recommended  treatment  with  curucuma-yellow  masks,  veils  or 
windows,  to  be  used  persistently  for  weeks  and  motjths. 

Bowles  relates  (Monatsh.  f.  pr.  Dermatologie,  1894,  Vol. 
XVIII,  p.  16)  that  an  officer  in  India,  who  suffered  much  from 
the  sun,  protected  himself  by  having  his  clothes  and  sun  helmet 
lined  with  yellow. 

Bouchard,  Widmark,  Hammer,  Ftnsen,  Moeller  and  Mak- 
lakow  have  all  made  direct  experiments  to  test  which  part  of  the 
spectrum  is  really  injurious.  Bouchard^)  used  coloured 
glasses  and  found  violet  to  act  more  strongly  than  the  rest. 

Widmark  ")  investigated  the  cause  of  erythema  photoelec- 
tricum.  He  used  the  light  of  a  powerful  electric  arc  lamp, 
concentrated  firstly  by  a  lens  of  rock  crystal;  secondly  a  glass 
plate  was  Introduced  between  the  irradiated  object  and  the  light- 
collecting  apparatus,  to  absorb  the  ultra-violet  rays.  Further, 
for  another  series  of  experiments,  in  order  to  make  parallel  the 
diverging  rays  from  the  source  of  light  and  to  cool  them  down, 
JVidmark  used  a  metal  tube,  closed  at  one  end  by  a  rock-crystal 
lens,  at  the  other  by  a  plain  sheet  of  glass  with  a  hole  in  it,  into 
which  a  disc  of  rock-crystal  was  cemented.  The  interior  of  the 
tube  was  filled  with  water,  kept  constantly  in  circulation. 

fVidmark's  experiments  showed  that  it  was  the  rays  which 
had  passed  through  the  rock-crystal  and  in  which  ultra-violet 
predominated  which  produced  erythema.  The  heat  rays  and 
bright  rays  played  only  a  subordinate  part. 

To  distinguish  the  action  of  light  rays  from  that  of  heat 
rays  Hammer  ^)  used  a  gas  lamp  with  an  Argand  burner  and  a 
ruby  glass  chimney.  Thus  the  ultra-violet  rays  and  all  the  light 
rays,  except  the  red  ones,  were  almost  entirely  excluded.  The 
upper  arm,  on  which  one  spot  was  marked  off  by  adhesive  plas- 
ter and  brown  paper,  was  then  exposed  and  held  at  about  to  to 
15  cm.  distance  from  the  flame.  A  fairly  intense  heat  was  felt. 
The  experiment  lasted  an  hour  and  a  half.  After  25  minutes 
the  skin  showed  distinct  redness  and  was  warm  to  the  touch.    At 


^)  Compt.  rend.  Soc.  Biolog.,  1877. 

^)  Hygiea,  1889,  Festband,  No.  3.    Verhandlungen  d.  biolog.  Vereins  in 
Stockholm,  1889,  20. — Skandin.  Archiv.  f.  Physiologic,  1889,  i. 

')  Ueber  den  Einfluss  des  Lichtes  aiif  die  Haut,  Stuttgart,  1891. 


PHO  TO  THERAPY  423 

the  end  of  the  experiment  the  skin  was  moderately  reddened  and 
showed  a  few  lighter  patches  within  the  red  part.  Then  white 
patches,  during  the  next  few  hours,  encroached  more  and  more 
on  the  red,  and  In  24  hours  the  skin  was  again  normal. 

It  was  further  noted  that  the  part  covered  by  the  plaster, 
but  not  that  which  was  covered  loosely  by  the  brown  paper,  was 
of  the  same  speckled  red  colour  as  the  exposed  skin. 

In  an  experiment  In  which  two  adjacent  strips  of  skin  were 
Irradiated  evenly  by  the  electric  light,  but  one  of  them  further 
exposed  to  the  light  of  a  gas  flame  with  a  ruby  glass  chimney, 
there  was  at  first  more  intense  reddening  of  the  latter  strip  and 
of  the  parts  near  It  covered  by  plaster,  but  later  on  both  the 
exposed  strips  showed  a  quite  even  degree  of  erythema. 

These  experiments  show  quite  clearly  the  difference  between 
the  action  of  heat  and  of  the  chemical  ultra-violet  rays  on  thq 
skin.  Both  produce  redness,  but  with  this  great  difference,  viz., 
that  redness  of  the  skin,  caused  by  heat,  appears  very  quickly 
and  disappears  as  quickly,  unless  the  heat  has  been  such  as  to 
make  albumen  fluid.  Redness  of  the  skin,  caused  by  the  ultra- 
violet rays,  on  the  other  hand,  shows  itself  for  the  most  part 
some  hours  later.  Is  very  persistent  and  Is  followed  by  desquama- 
tion and  by  pigmentation. 

In  Maklakozvs  opinion,^)  the  effect  of  an  arc-light  on  the 
skin  Is  not  thermal,  but  chemical  and  very  like  that  produced  by 
Insolation.  Yellow  and  red  light,  which  have  no  chemical  rays, 
have  also  no  effect  on  the  skin.  Less  powerful  sources  of  light 
produce  no  marked  effect  on  the  skin,  but  lead  to  discolouration, 
if  applied  for  a  long  time  continuously.  Long  exposures  or  very 
Intense  light  set  up  necrotic  changes:  the  skin  becomes  gangre- 
nous as  a  result  of  the  chemical  light  action. 

Finsen  ^)  exposed  certain  parts  of  the  skin  to  all  the  rays  of 
the  spectrum,  other  parts  to  certain  rays  only.  For  this  purpose 
he  fixed  on  his  arm  a  rock-crystal  disc  and  a  row  of  variously 
coloured  pieces  of  glass,  and  painted  on  the  arm  a  few  letters 
and  stripes.     All  these  articles  and  colours  were  so  arranged  on 


')  L.  c. 

')    Mittheiliingcn  aiis  I'iiiscn's  mcd.  T.irlitinsliliit,  T,  p.  Q. 


424  RADIO-THERAPY 

the  arm  that  the  skin  surrounding  each  figure  was  exposed  to 
the  full  influence  of  all  the  light  rays;  the  arm  was  exposed  for 
lo  minutes  to  the  light  of  an  80  ampere  lamp  at  a  distance  of 
75  cm.  The  skin  was  slightly  reddened  at  once;  after  2  hours 
the  redness  had  increased,  after  4  hours  it  had  increased  still 
more,  but  only  in  the  parts  which  had  not  been  covered.  After 
12  hours  in  all  the  skin  was  quite  dark  red,  hot  and  sensitive. 
Wherever  the  skin  had  been  covered  during  the  experiment  with 
paint,  it  was  now  quite  white  and  normal,  standing  out  sharply 
against  the  red  surroundings;  the  two  letters  were  very  clear, 
white  on  a  red  ground.  Where  the  five  pieces  of  glass  had  been 
there  were  five  white  streaks  of  the  irregular  shape  of  the  glass, 
and  the  skin  at  these  places  was  throughout  quite  normal.  On 
the  other  hand,  at  the  part  where  the  rock-crystal  had  been  the 
skin  was  quite  the  same  colour,  and  quite  as  hot  and  sensitive  as 
at  the  parts  which  had  not  been  covered  at  all. 

Thus  this  experiment  again  showed  that  light  erythema  is 
caused  by  the  ultra-violet  rays.  In  a  second  experiment  Finsen 
collected  the  arc-light  through  a  quartz  lens  and  held  variously 
coloured  bits  of  glass  and  also  rock-crystals  in  front  of  it.  At 
the  same  time  means  were  taken  to  pass  the  light  through  a  layer 
of  cold  water,  and  the  irradiated  spot  was  played  on  with  a 
stream  of  cold  water.  Reaction  of  the  skin  resulted  at  the  three 
spots  where  the  light  acted  through  rock-crystal,  clear  glass,  and 
blue  glass,  but  not  the  slightest  reaction  appeared  with  the 
other  colours.  From  which  we  may  infer  that  not  only  the 
ultra-violet,  but  also  the  visible  chemical  rays  have  the  power 
of  producing  erythema  photoelectricum. 

A  question  of  great  interest  to  determine  is,  how  deep  does 
the  light,  and  especially  the  so-called  chemically  active  rays, 
penetrate  into  the  tissue?  Since,  as  has  been  shown,  a  peculiar 
influence  on  the  phenomena,  appearing  after  insolation,  has 
been  ascribed  to  the  ultra-violet  rays  in  particular,  it  seemed  to 
the  author  important  to  test  how  far  the  latter  assumption  is 
justified.  Attention  was  directed  not  as  to  whether  the  ultra- 
violet rays  did  as  a  matter  of  fact  produce  the  effects  here  dis- 
cussed, but  as  to  whether  these  rays  were  capable  of  having  any 
effect  on  those  structures  situated  deep  in  the  corium  (capillary 


PlIO  TO  THERAPY  425 

vessels,  ends  of  nerves,  chromatophorcs,  etc.),  iror.i  which 
various  unhealthy  conditions  of  the  skin  have  their  origin.  The 
outermost  ultra-violet  rays,  being  for  the  most  absorhiiblc  by 
various  transparent  media,  c.  g.,  glass,')  it  was  a  matter  of 
interest  to  find  out  whether  the  opaque  layers  of  epidermis  pre- 
vent to  any  sensible  extent  the  passage  of  these  rays.  The 
reply  to  this  question  has  a  further  practical  interest,  at  the  pres- 
ent time,  when,  owing  to  the  favourable  results  reported  by 
Finsen  on  the  light  treatment  of  lupus,  so  much  attention  is 
being  given  to  the  irradiation  of  parasitic  affections  with 
so-called  chemical  rays.  Quite  recently,  indeed,  Strebel  has 
been  substituting  for  Finsen's  treatment  with  electric  arc-light 
irradiation  with  the  ultra-violet  light  of  the  induction-spark,  and 
he  claims  to  have  destroyed  bacterial  cultures  far  more  quickly 
with  this  than  with  the  arc-light.  Under  these  circumstances 
it  Is  specially  Important  to  determine  the  transparency  of  the 
epidermis  for  ultra-violet  rays.  For  if  the  ultra-violet  rays  are 
indeed  so  powerful  In  their  action,  and  If  In  practice  they  are 
actually  able  to  bring  their  action  to  bear  on  the  deeper-lying 
layers  of  the  skin,  /.  e.,  if  they  are  not  intercepted  by  absorption 
in  the  surface  tissues,  then  it  would  surely  be  well  to  use  as  little 
as  possible  the  visible  constituents  of  the  spectrum,  and  to  make 
use  only  of  such  sources  of  light  as  emit  the  greatest  proportion 
of  ultra-violet  rays. 

In  the  author's  experiments  In  this  direction  he  wished, 
therefore,  not  merely  to  test  whether  the  chemical  and  ultra- 
violet rays  are  able  to  penetrate  to  the  lower  layers  of  the  skin, 
but  to  determine  as  exactly  as  possible  which  part  of  the  ultra- 
violet spectrum  has  this  peculiar  penetrating  power. 

It  has  long  been  known  that  animal  tissues  allow  of  the  free 
passage  of  light,  or  at  least  of  certain  constituents  of  it,  and 
before  the  discovery  of  Roentgen-rays  this  transparency  of  the 
tissues  was  largely  taken  advantage  of  to  investigate  the  char- 
acter and  seat  of  morbid  changes  within  the  human  body.      'I'his 


')  See  the  treatise  by  Edcr  and  I'alciUa.  Die  Spectrcn  farhlosrr  uiul  Re. 
faerbter  Glaeser.  Denkschr.  d.  kais.  Akad.  d.  Wissensch.  Malh.-natiirw.,  CI, 
Vol.  LXI. 


426  RADIO-THERAPY 

transparency  Is  present  in  various  tissues  In  a  varying  degree;  it 
depends  not  only  on  the  density  and  chemical  nature  of  the 
layer,  but  especially  on  Its  uniformity,  as  regards  both  matter 
and  density.  Most  substances  found  In  the  human  body  are  not 
equally  transparent  to  all  colours;  they  absorb  the  rays  of  one  or 
several  colours  and  allow  passage  to  rays  of  the  other  colours. 

The  transparency  of  the  skin  is  shown  by  the  simple  experi- 
ment of  holding  the  hand  In  front  of  a  strong  light,  when  the 
finger  tips  will  show  the  red  light  through,  or  of  looking  at  the 
sun  with  closed  eyes,  when  a  sensation  of  red  light  will  be  felt. 
The  red  colour  shows  that  the  red  rays  have  penetrated  the  tis- 
sues. The  commonly  used  test  for  hydrocele  also  shows  In 
simple  fashion  that  light  penetrates  the  skin  of  the  scrotum. 
Dessaignes^)  demonstrated  the  passage  of  light  through  the 
skin  by  making  a  diamond  sparkle  when  the  finger  covering  It 
v/as  Illuminated  from  above.  A  similar  result  followed^ when 
the  light  had  to  find  its  way  through  a  white  or  chamois  leather. 

An  experiment  of  Gadncfs  -)  threw  further  light  on  the 
nature  of  the  rays  penetrating  the  skin.  He  filled  small  tubes 
with  chloride  of  silver,  sealed  them  hermetically,  and  then  with 
the  aid  of  a  trochar,  introduced  them  under  the  skin  of  dogs  and 
cats.  When  the  animals  had  been  exposed  for  some  time  to 
the  sunlight,  the  chloride  of  silver  was  found  to  be  blackened, 
whilst  with  animals  In  captivity,  which  had  been  kept  in  the 
dark,  It  was  unchanged.  Finsen  proved  the  passage  of  light 
through  the  skin  by  placing  sensitised  paper  behind  the  lobe  of 
the  ear  and  Irradiating  the  latter.  The  paper  was  blackened, 
and  to  a  more  marked  extent  when  the  blood  was  driven  out  of 
the  skin  by  pressure.  Darho'ts  ^)  showed  that  a  piece  of  photo- 
graphic paper  introduced  Into  the  mouth  under  the  skin  of  the 
cheek  between  two  watch  glasses  was  blackened  after  one  min- 
ute by  light  from  the  Finsen  concentrator,  directed  on  the  out- 
side of  the  cheek.  Gebliard  *)  Inbedded  a  hand  so  completely 
in  plaster  of  Paris  that  only  the  back  of  the  hand  was  exposed. 


^)  Quoted  by  Gehhard. 

')  Quoted  by  Boubnoff,  Arch.  f.  Hyg.,  Vol.  X,  p.  335. 

')  P.  Parbois,  Traitement  du  lupu.s  vulgaire.  The.se  dc  Paris,  1901,  p.  80. 

*)  Die  Heilkraft  des  Lichtcs,  Leipzig,  i8g8,  p.  131. 


PHO  TO  THERAPY  427 

A  photographic  plate  had  been  placed  in  the  hollow  of  the  palm. 
Then  the  hand  was  exposed  for  20  minutes  to  the  light  of  an 
electric  arc-lamp  and  afterwards  (in  the  dark  room)  taken  oft 
the  plate  and  the  latter  developed.  The  plate  was  blackened, 
the  contours  of  the  hand  and  fingers  being  distinctly  seen — a 
sign  that  light  had  passed  through  the  hand.  Similar  experi- 
ments were  made  mBechtere^iv's  laboratory  by Solucha^).  Tubes 
filled  with  strips  of  silver-bromide-gelatine  were  inserted  under 
the  skin  of  dogs  and  the  wound  sewn  up.  Light  was  projected 
on  the  parts  from  an  electrical  projection-apparatus  of  10  to 
20  amperes  current  strength  and  50-65  volts.  After  >4  minute 
the  bromide  of  silver  was  seen  to  be  decomposed.  When,  on 
the  other  hand,  the  tubes  were  inserted  deep  down  into  the  mus- 
cle substance  of  the  glutei,  the  light  had  no  effect.  When  the 
tubes  were  put  behind  the  ear  or  inside  the  cheek  of  patients, 
decomposition  soon  set  in ;  in  the  former  case  after  half  a  minute, 
in  the  latter  after  2  minutes; when  placed  behind  the  fore-arm  or 
in  the  fist  the  bromide  of  silver  was  unchanged  after  15  minutes. 

With  a  current,  then,  of  the  above-mentioned  strength,  light 
only  penetrates  through  the  skin;  with  a  stronger  current,  say  of 
25  amperes  and  no  volts,  it  penetrates  through  the  whole  body, 
for  under  such  conditions  the  sensitised  gelatine-film  was  chemi- 
cally altered,  even  when  it  was  placed  on  the  opposite  side  of  the 
body  from  the  part  exposed  to  the  light.  Thus  Sohicha  placed 
it  at  the  back  of  the  neck  when  he  exposed  the  front  of  the 
throat,  or  at  the  right  side  of  the  body  when  the  light  came  from 
the  left.  Kiinc  and  Hortatler  -)  proved  that  sun  rays,  too,  may 
pass  through  the  human  thorax  and  still  have  sufficient  power 
to  produce  an  image  on  a  photographic  plate.  F'uiscn  ^) 
passed  concentrated  sunlight  through  the  ear  of  a  white  rabbit 
on  to  a  bacteria  culture.  After  ■/]  hour  he  was  able  to  observe 
distinct  weakening  or  killing  of  the  culture. 

Finsen  also  proved  with  the  skeptroscope  that  a  light  ray 


^)  Wissenschaftl.  Sitz.  d.  Vcrcinig.  d.  Pctcrsburger  Klinik  f.  Ncrvcn- 
und  Geisicskrankheitcn,  24.  Fcbruar,  1900,  Wratsch,  1900,  Nr.  28,  p.  864. 

*)   Allgem.  Photogr.-Ztg.,  1901.  p.  4^2. 

')  Uc1)cr  die  Anwcndnng  von  cuncciilrirtcn  chcmischcn  Lichtslralik-n  in 
der  Medicin,   Leipzig,   1899,  p.  Ji. 


428  RADIO-THERAPY 

passed  through  the  compressed  lobe  of  a  human  ear  could  still 
be  broken  up  clearly  into  all  the  colours  of  the  spectrum. 

The  quality  possessed  by  the  ultra-violet  rays  of  making 
bodies  shine  which  are  capable  of  fluorescence  furnished 
Strehel^)  with  the  means  of  prov^ing  the  permeability  of  the 
human  skin.  The  result  of  these  experiments  he  gave  as  fol- 
lows: "Glass  absorbs  ultra-violet  light  powerfully,  but  epider- 
mis absorbs  it  vastly  more.  A  plate  of  horn,  about  i  mm. 
thick,  eclipsed  the  spectrum  from  line  410  onwards  and  seemed, 
therefore,  to  be  very  slightly  transparent.  A  human  ear  com- 
pressed between  quartz  plates  absorbed  isolated  ultra-violet 
concentrated  light  completely."  In  a  later  communication 
Strebel  reports  on  the  following  experiment:  "A  piece  of  skin 
freed  from  all  fat-tissues  was  fixed  between  small  quartz 
plates,  and,  all  coloured  rays  being  excluded,  was  irradiated 
with  concentrated  ultra-violet  light,  produced  by  induction 
sparks  from  zinc  and  aluminium  electrodes;  the  illuminated 
object  was  140  cm.  distant  from  the  spark.  The  fluorescent 
screen,  put  up  behind  the  skin,  now  showed  a  faint  but  quite  dis- 
tinct luminescence." 

The  experiments  here  given  show  that  not  only  the  optical 
rays,  but  also  the  chemically  active  ones  are  able  to  pass  through 
animal  tissue,  even,  under  certain  conditions,  through  a  layer  of 
considerable  thickness. 

As  above  stated,  the  task  the  author  had  set  himself  was  to 
investigate  ( i )  whether  the  ultra-violet  rays  can  penetrate  the 
epidermis  and  reach  the  lower  lay-ers  of  skin,  and  (2)  which 
part  of  the  ultra-violet  spectrum  has  this  peculiar  property. 

It  was  only  by  means  of  the  spectrograph  that  the  task  could 
be  solved  with  accuracy,  for  even  though  Strehel's  experiments 
furnished,  as  It  were,  the  qualitative  proof  (by  the  lighting  up  of 
the  fluorescent  screen)  of  the  power  of  the  ultra-violet  rays, 
under  given  circumstances,  to  penetrate  the  skin,  still  only  spec- 
trographlc  examination  of  the  penetrating  light  could  determine 
precisely  and  certainly  which  constituents  of  the  light  possessed 
this  power. 


')   Deutsche  med.  Wochenschr.,  1901,  Nos.  5,  6. 


PHOTOTHERAPY  429 

In  the  spectroscope  commonly  used,  as  is  well  known, 
light  is  decomposed  into  its  constituent  parts  by  means 
of  a  glass  prism.  But  glass,  like  many  other  transpar- 
ent media,  has  the  disadvantage  of  absorbing  some  parts 
of  the  spectrum  and  ultra-violet  rays  in  particular.  For 
this  reason,  in  these  experiments  a  spectroscope  with 
glass  prism  was  not  employed,  but  a  so-called  "grating" 
spectroscope,  which  produces  a  refraction-spectrum. 

llie  experiments  were  undertaken  in  the  photo- 
chemical laboratory  of  the  Imperial  Graphische  Lehr  u. 
Versuchs-Anstalt,  in  Vienna,  under  the  supervision  of 
Prof.  Editard  Valenta.  The  author  used  as  material 
fresh  epidermis  (i)  from  burn-blisters,  (2)  from  the 
bulhc  of  pemphigus  vulgaris.  Both  were  carefully 
removed  with  scissors,  placed  on  glass  plates,  and  with 
them  preserved  in  the  fluid,  withdrawn  from  the  blisters 
by  a  small  pipette  during  the  short  distance  from  the 
sick-room  to  the  laboratory.  (3)  Fragments  of  epider- 
mis (from  animals)  which  were  kept,  like  the  two  other 
preparations,  in  normal  saline  solution. 

These  various  membranes  were  now  spread   care- 
fully on  one  quartz   plate   and  covered  with   another^ 
Then  with  a  strong  magnifying  glass  it  was  seen  that 
the  preparation  showed  no  gaps  or  tears.     The  quartz 
plates  were   fastened   in    front  of  the  opening  of  the 
"grating  spectroscope."       As   the   source   of   light   the 
spark    was    used    (intensified    by    Leyden    jars)     from 
a    powerful    Ruhmkorff    coil;    the    electrodes    between 
which  the  spark  passed  were  coated  with  an  alloy  of 
lead,    zinc    and    cadmium   {Edcr's  alloy).    The    spec- 
trum of  this  light  source,  set  up  at  about  40  cm.  from 
the  opening,   was  now  photographed,   first  with,   then 
without,   insertion  of  the  preparations.       The  opening 
was  0.2  mm.  wide;  time  of  illumination,   15  minutes. 
The    experiments    showed    that    under    these    conditions 
absorption  of  the  ultra-violet  rays  begins  at  the  cadmiun  line, 
X  =  3260  ///%  /.  t'.,  that  this  line,  under  the  given  conditions,  is 
just  recognisable  on  the  film,  whilst  the  light  of  the  more  refraii- 


430  RADIO-THERAPY 

gible   rays   no   longer  produces   blackening,    being,    therefore, 
absorbed. 

There  was  no  marked  difference  in  the  transparency  of  the 
three  different  preparations. 

In  consequence  of  this,  we  may  assume  with  certainty  that, 
of  the  blue,  violet  and  ultra-violet  rays,  those  up  to  the  wave- 
length of  the  cadmium  line  penetrate  the  epidermis. 

The  following  experiments  were  made  for  the  pur- 
pose of  comparing  the  behaviour  of  dried  epidermis 
with  that  of  moist,  fresh,  normal  epidermis:  Films  of 
almost  colourless  horn  and  of  horn  coloured  slightly 
yellow,  0.5  and  0.56  mm.  in  thickness,  respectively, 
served  as  material.  They  were  tested  by  examination 
under  sunlight  with  the  lattice  spectroscope  above  men- 
tioned. 

The  yellowish  horn,  with  an  opening  of  o.i  mm. 
and  an  illumination  of  80  seconds,  allowed  the  ultra- 
violet light  up  to  the  Fraunhofer  line  O  (A=  3440  AE) 
to  pass  through;  under  the  same  conditions  with  the  col- 
ourless horn  the  ultra-violet  rays  were  effective  up  to 
Q    {X=32S7JE). 
Whilst,  then,  colourless,  dead  epidermis  has  on  the  whole 
the  same  absorptive  power  as  the  living  epidermis,  the  permea- 
bility of  coloured  (pigmented)  epidermis  was  shown  to  be  sen- 
sibly less  than  that  of  the  former. 

According  to  Finsen  (see  p.  438),  the  blood  circulating  in 
the  skin  hinders,  to  a  marked  extent,  the  entrance  of  the  chemi- 
cally active  rays.  It  was  for  this  reason  that  he  constructed 
his  compression  apparatus,  which  also  enabled  him  to  lessen  con- 
siderably the  duration  of  the  treatment. 

To  determine  spectroscopically  the  extent  to  which 
the  more  refrangible  rays  are  absorbed  by  the  blood,  a 
few  drops  of  blood  from  the  finger  tips  were  squeezed 
on  to  a  quartz  film,  which  was  surrounded  by  a  rim  of 
paper  0.17  mm.  wide,  and  covered  with  another  quartz 
film.  The  blood  completely  filled  this  space  of 
0.17  mm.  This  layer  showed  a  uniformly  red  colour, 
without  any  light  space.     On  examination  with  a  little 


PHOTOTHERAPY  431 

pocket  spectroscope,  the  usual  absorption  spectrum  of 
blood  was  seen,  with  the  characteristic  absorption  band 
between  the  Fraunhofer  lines  D  and  E  in  the  greenish 
yellow. 

Now,  by  the  aid  of  a  small  glass  spectroscope,  using 
sunlight,   the   spectrum  was   photographed.     With   an 
exposure  of  5  minutes  the  image  of  what  had  been  seen 
was  reproduced. 
The  absorption  began  at  E  }  G  and  from  that  point  onward, 
in  the  direction  of  ultra-violet,  practically  no  action  on  the  pho- 
tographic plate  was  discernible. 

The  experiments  so  far  described  concerned  only  epider- 
mis and  blood.  A  further  experiment  was  made  in  order  to 
discover  what  is  the  behaviour  of  living  fresh  epidermis  beneath 
which  blood  is  circulating. 

A  frog  was  put  under  curari,  then  two  toes  of  a 
hind-foot  were  fastened,  with  pegs,  in  such  a  manner, 
along  the  edges  of  a  triangular  hole,  cut  in  a  sheet  of 
cork,  that  the  web  of  the  foot  was  stretched  tight  across 
the  hole.     The  cork  was  fixed  in  front  of  the  opening 
of  the  lattice  spectroscope.      Sunlight  was  used  as  the 
source  of  light.   The  opening  was  0.15  mm.,  the  expos- 
ure, 5  minutes. 
It  was  shown  that  under  these  conditions  the  light  from 
line  H  (A  =  3964  AE)    onwards  was    absorbed.      When    we 
take  into  account  the  thickness  of  the  membrane,  the  quantity  of 
blood  contained  in  it,  etc.,  it  is  interesting  that  so  many  light 
rays  from  the  more  refrangible  part  of  the  spectrum  should  still 
be  able  to  pass  through. 

From  all  these  experiments  it  follows  that  a  considerable 
portion  of  the  ultra-violet  rays  emitted  by  various  sources  of 
light  pierces  the  epidermis  and  is  able  to  reach  the  lower  lay- 
ers of  the  skin.  The  amount  of  these  rays  corresponds  roughly 
with  the  third  part  of  the  ultra-violet  spectrum  as  at  present 
more  exactly  known. 

Naturally,  these  results  are  influenced  by  the  Intensity  of  the 
source  of  light,  the  duration  of  the  action  and  the  thickness  of 
the  exposed  layer.     With  suitable  experimental  arrangements, 


43  2  RADIO-  THERAP  Y 

we  might,  therefore,  observe  still  more  favourable  conditions  of 
the  epidermis  as  regards  permeability. 

We  may  here  once  more  refer  to  the  fact,  proved  by  recent 
photo-chemical  research,  that  chemical  action  is  traceable  not 
only  to  light  rays  of  short  wave  length,  but  to  rays  of  each 
and  every  wave  length  {i.  e.,  colour) ,  according  to  the  nature  of 
the  body  they  fall  on.  Light  falling  on  a  body  and  being 
absorbed  by  it  will  either  produce  chemical  results  (processes  of 
conversion  by  oxidation),  or  it  will  be  converted  into  heat  with- 
out producing  chemical  change  (absorption  phenomena,  in  the 
case  of  substances  coloured  with  pure  spectrum  colour),  or  it 
gives  rise  to  electric  phenomena,  setting  up  electric  currents  or 
influencing  the  electric  conductibility  of  the  insulated  substance. 
These  phenomena  seldom  have  a  perfecly  simple  course,  they 
are  usually  complicated  by  various  simultaneous  processes  of 
similar  kind.  It  is  true  that  most  bodies  are  chiefly  affected  by 
the  short-lengthed  rays,  but  it  is  very  doubtful,  seeing  how  dif- 
ferently the  various  animal  tissues  and  fluids  are  affected  by 
light  and  how  various  are  their  absorption  spectra,  whether  we 
can  group  under  one  designation  the  action  of  any  one  special 
kind  of  light  on  the  human  organism.  We  may  refer  here  to 
the  different  absorption  spectra,  given  by  blood  corpuscles  and 
albuminous  substances,  the  former  absorbing  long  waved  light 
from  certain  parts  of  the  spectrum  as  well  as  part  of  the  blue 
and  ultra-violet  rays,  while  the  latter  absorb  mainly  the  short 
waved  rays. 

In  any  case,  as  is  evident  from  their  absorption  spectra,  ani- 
mal organic  substances  react  readily  to  light.  This  fact  is 
borne  out  by  the  purely  empirical  observations  as  to  the  physio- 
logical effects  on  the  organism.  Moeller'^)  made  Investiga- 
tion with  the  view  of  discovering  what  changes  of  tissue  in  the 
skin  observable  under  the  microscope  corresponded  to  the  vari- 
ous clinical  pictures  of  ordinary  sunburn  and  other  more  serious 
light  disturbances. 

As  material  he  took  skin  from  the  head  and  the  ear  of  rab- 
bits, as  well  as  the  skin  of  his  own  fore-arm.    He  used  in  the 

')  L.  c,  p.  28. 


PHOTOTHERAPY  433 

experiments  electric-light  arc-lamps  of  1 200-1400  normal 
candle-power.  By  varying  the  distance  between  the  source  of 
light  and  the  skin,  as  well  as  the  time  of  exposure,  and  by 
repeated  irradiation  of  the  same  part  of  the  skin,  he 
obtained  \arious  degrees  of  effect  from  faint  erythema 
with  consequent  slight  discolouration  and  pigmentation  to 
more  marked  changes,  such  as  redness  and  swelling,  forma- 
tion of  vesicles,  necrosis,  etc.  By  filtering  away  the  heat  rays 
Moeller  allowed  only  the  so-called  chemically  active  rays  to  act 
on  the  skin.  For  his  experiments  he  used  Jrid})icirk's  appara- 
tus (see  p.  422) . 

Specimens  for  histological  examination  were  taken  from  the 
dermatitis  of  various  degrees  thus  produced. 

The  following  objects  were  microscopically  examined: 

1.  Human  skin,  after  slight  erythema,  photoelectricum  had 
been  produced  (object  a). 

2.  Grayish-toned,  thickened,  rigid,  but  not  yet  pigmented 
skin  from  the  head  of  a  rabbit  (object  b) . 

3.  Skin  from  the  ear  of  an  albinotic  rabbit,  hypera^mic, 
oedematous,  dotted  with  little  blisters. 

4.  The  ear  of  an  albinotic  rabbit  showing  more  marked 
change,  swollen  on  both  sides,  hyperasmic,  showing  ecchymosis 
and  blisters. 

5.  A  piece  of  human  skin,  which  had  been  exposed  to  the 
rays  and  on  which  a  mulberry-shaped,  irregular,  dark-red 
hzemorrhagic  blister  had  formed. 

A  review  of  the  microscopic  changes  found  in  these  various 
specimens   {a — r)  seems  to  warrant  the  following  conclusions: 

"The  first  change  to  show  itself  in  the  exposed  skin  is  in  the 
vessels,  which  become  microscopically  more  or  less  dilated.  In 
connection  with  this  the  epithelium  becomes  moist  through- 
out, and  there  is  an  abnormal  formation  of  horny  matter 
(parakeratosis)  of  a  changed,  darker  colour.  The  prickle-cell 
layer  of  the  ej^idermis  and  the  horny-layer  appear  much 
extended.  Within  the  latter  is  a  tleep  coloured  strij),  which 
consists  of  horn  cells  with  their  nuclei   ( I'ig.  90). 

MocUir  surmises  that  the  skin,  which  shows  microscopically 
no  other  change  than  a  yellowish-brown  colour,  gets  its  colour 


434 


RADIO-THERAPY 


from  this  abnormal  strip  of  nucleated  cells.  With  more  intense 
or  long-continued  action  of  the  irritant  exudation  supervenes, 
which  is  sero-fibrinous  or  rich  in  cells;  it  may  often,  also,  con- 
tain red  blood  corpuscles.  The  changes  are  more  or  less  deep 
seated  in  proportion  to  the  intensity  of  the  light  and  the  differ- 
ent nature  of  the  exposed  skin  (whether  human  or  of  rabbits, 
etc.).  More  or  less  evident  derangement  of  the  parts  may 
arise,  dependent  on  the  intensity  of  the  exudation;  the  collage- 
nous tissue  begins  to  swell  and  become  homogeneous,  the  epithe- 
lium swells,  becomes  relaxed,  infiltrated,  and  raised  in  bullae. 


:i  ,^  J;  W§m^  Sfcii^R  =r%;I^K^ 


& 


J 


Fig.  90. 


The  interruption  of  continuity  occurs  in  various  places.  With 
the  human  being  it  occurred  approximately  on  the  border 
line  between  the  granular  and  the  horny  layers,  but  this  by  no 
means  precludes  the  possibility  that  on  other  occasions  (other 
skin  and  other  degree  of  light  intensity)  the  bullous  exudation 
may  arise  differently.  This  would  be  analagous  with  the  course, 
e.  g.,  of  pemphigus,^)  where  in  some  cases  the  blisters  appear 


')  Jarisch,  Zur  Anatomic  u.   Pathogenese  der  Pemphigusblasen.  Arch.   f. 
Derm.  u.  Syph.,  1898.    Festschrift  gewidmet  F.  J.  Pick,  Part  II,  p.  341. 


PHOTOTHERAPy 


435 


between  the  cutis  and  the  rete,  in  others  between  the  granular 
and  the  horny  layer.  With  more  intense  light  thrombi  are 
formed  in  the  vessels  of  the  cutis." 

In  MoclUr's  case  the  contents  of  the  blister  con- 
sisted of  a  fine  reticulum,  containing  numerous  red  cor- 
puscles and  isolated  leucocytes.  Everywhere  close  to 
the  surface  numerous  light,  round  blisters  are  to  be  seen, 
with  a  more  or  less  delicate  covering  membrane  and  a 
light  centre  (Fig.  91).  In  some  of  the  horn-cells,  loos- 
ened from  the  covering  of  the  bulla,  may  be  seen  very 
distinctly  through  the  swelling  of  the  cells,   a   longish 


gfe-ajSafefe-L-.w-:---.'! 


tfc 


Fig.  91. 


Fig.  92. 


rod-shaped  hole  in  the  centre  in  place  of  the  nucleus.    In 
the  remaining  [:)ricklc-layer,  too,   \\hich  forms  the  base 
of  the  blister,  cell  changes  occur,  which  wary  Irom  a  sim- 
ple swelling  to  bullous  degeneration   ( I'ig  92). 
It  was  interesting  to  ha\'e  confirmation  of   the  tact  of   the 
deeply-penetrating   action   of   the   ultra-\  lolct    rays,    which    was 
seen  very  beautifully  in  the  rabbit's  ear.      /'Or  the  (I'isliirlxuircs 
were   {when  the  li^lit  was  very  iuWusc)   very  nitirkcd,  also  on 
the  reverse  side  of  the  enrlihi'^e:  nay,  in  consecjuence,  no  iloubt, 
of  the  larger  number  of  vessels  on   that  side,  they  were  more 
noticeable  there  than  on  the  directly  illuminated  side. 


436  RADIO-THERAPY 

In  a  further  series  of  experiments  Mocller  proved  that  heat 
radiation  (50"  to  55°)  acting  together  with  intense  ultra-violet 
irradiation,  just  the  same  as  heat  radiation  alone,  after  the  filter- 
ing away  of  the  ultra-violet  rays,  when  directed  on  the  skin  of 
the  skull  of  rabbits,  produced  more  or  less  intense  cerebral  dis- 
turbances, sometimes  even  sudden  death.  The  autopsy  showed 
the  skin  of  the  head,  after  intense  irradiation  of  that  nature,  to 
be  much  swollen,  and  a  bloody  gelatinous  exudation  to  be  pres- 
ent in  the  subcutaneous  tissue.  The  periosteum,  the  cranial 
bones,  the  dura  were  discoloured  and  covered  with  ecchymoses. 

The  vessels  of  the  brain  surface  were  much  dilated,  and  it 
showed  numerous,  in  part  confluent,  ecchymoses.  When,  on 
the  other  hand,  the  heat  rays  were  filtered  oft  and  the  ultra-vio- 
let rays  alone  applied,  no  central  disturbance  was  observable. 

These  last  experiments  show  that  tlie  action  of  the  ultra-vio- 
let rays  at  any  depth  is  relatively  tinimportaut.  No  change  of 
tissue  w^as  to  be  seen,  even  in  the  spongy  subcutaneous  tissue, 
this  in  direct  contrast  to  the  condition  after  irradiation  by  heat 
rays.  Both  heat  rays  and  ultra-violet  rays  cause  hyperaemia  of 
the  cutis,  followed  in  the  case  of  the  latter  rays  by  discoloura- 
tion and  hyperplasia  of  the  epidermis,  especially  of  the  horny 
layer,  which  prevents  them  from  penetrating  further  into  the 
tissues. 

No  less  important  than  the  changes  in  the  skin  are  those 
which  light  produces  in  the  A'isual  organs.  Ogneff^)  asserts 
that  prolonged  action  of  an  electric  arc-light  of  high  power,  with 
preponderance  of  violet  and  ultra-violet  rays,  produces  necrosis 
in  the  cells  of  the  cornea  in  the  case  of  rabbits,  pigeons  and 
frogs.  In  the  cells  of  the  cornea,  necrosis  Is  preceded  by  ami- 
totic nuclear  changes  (whilst  with  brief  exposure  mitosis  results) . 
Of  the  other  parts  of  the  eye,  the  lens  and  the  vitreous  humour 
are  not  aftected  at  all,  the  retina  only  slightly.  Ogneff  believed 
he  guarded  against  any  action  of  temperature  in  his  experiments. 

Light,  acting  on  the  retina,  bleaches  (Kuehiie  -)  the  red-col- 
ouring matter,  "rhodopsin,"  proved  by  Boll  to  be  present  in  the 


')   Pflucgcr's  Arch.,   Vol.  LXIII,  p.  209. 

°)   Untersuch.  a.   d.  physiol.  Injtitut  Hcidelb.,  Vol.   I,  u.   ff. 


PHOTOTHERAPY  437 

outermost  portion  of  the  rods.  It  Is  extremely  doubtful,  how- 
ever, how  far  this  affects  the  power  of  sight. 

By  means  of  the  local  bleaching  of  the  rhodopsin,  images 
of  light  objects  on  a  dark  background  {e.  g.,  illuminated  win- 
dows), may,  as  though  by  a  photographic  process,  be  obtained 
white  on  red  in  the  eyes  (previously  kept  in  the  dark)  of  either 
living  or  dead  frogs  and  rabbits.  (In  the  case  of  dead  animals, 
the  eyes  are  cut  out.)  These  images  may  be  fixed  by  means  of 
alum  ("optograms"). 

The  pigment  granules,  when  the  eye  is  in  the  dark,  i.  e.,  in  a 
state  of  rest,  lie  at  the  back  of  the  pigment  cells  of  the  epithe- 
lium, nearest  the  nucleus;  when  light  falls  on  the  retina,  the 
granules  move  forward  into  the  ciliary  processes,  lying  between 
the  rods  and  cones,  and  the  rods  and  cones  themselves  draw 
together  and  contract.  {Boll,  Angelucci,  Engebnann,  v.  Gen- 
deren,  Heger,  Per  pens  and  E.  Fiichs})  )  A  retina  that  has 
been  kept  in  the  dark  changes  its  electrical  condition  when  light 
suddenly  falls  upon  it;  the  electric  current  which  passes  normally 
from  the  retina  to  the  brain  is  made  stronger  {Holmgren) . 
The  so-called  photo-electrical  variations  may  be  here  referred 
to:  for  the  eye  accustomed  to  darkness  the  maximum  of  stimu- 
lation is  found  in  yellowish  green  close  to  the  thallium  line, 
whilst  the  eye  adapted  to  the  light  reacts  most  to  the  yel- 
low D  line  of  the  spectrum  {Himstedt  and  Nagel'-)). 
Engelmann")  proved  that  frogs,  from  whose  eyes  light  was 
artificially  excluded,  reacted  with  contraction  of  the  interior 
cones  of  the  retina  to  irradiation  of  the  skin  of  the  back. 
This  fact  proves  that  the  light  stimulus  reaches  the  brain  by  a 
centripetal  course,  and  is  able  thence  to  induce  motor  phe- 
nomena. Buedingen  has  shown  that  this  reflex  action  does 
not  take  place  when  the  brain  is  removed,  whence  w'C  may  con- 
clude that  this  transformation  of  the  stimulus  takes  place  within 
the  brain  itself. 

According  to  the  researches  of  Bence  Jones,  Diipre  and 
John  Tyndall,  the  lens  possesses  the  power  of  fluorescence  in  a 


'j   Lelirlx  d.  Augcnlicilk,  Leipzig  unci  Wien,  189.3. 
')    Physik.  Zeitschr..  1901,  Jahrg.  II,  p.  362. 
»;  Pdueger's  Arch.,  1885,  Vol.  XXXV,  p.  498. 


438  RADIO-THERAPY 

high  degree.  "If  I  bring  my  eye  into  a  violet  ray,  I  notice  a 
bluish-white  glimmer  filling  the  space  In  front  of  me.  This 
glimmer  comes  from  the  fluorescent  light  produced  in  the  eye 
itself.  The  crystalline  hue  of  the  eye,  when  looked  at  from 
without,  lights  up  brightly  at  the  same  time  ^ ) ." 

This  peculiarity  of  the  lens,  which  it  shares  in  common  with 
the  vitreous  body,  may  perhaps  explain  why  Roentgen  and 
Becquerel  rays  produce  sensations  of  light  with  some  persons. 
It  is  not,  however,  impossible  that  electric  stimuli  of  the  retina 
and  the  visual  nerve  may  have  something  to  do  with  it. 

Of  great  importance,  in  connection  with  the  effects  of  light 
on  the  whole  human  and  animal  organism,  Is  the  influence  which 
it  exercises  on  the  blood  and  the  capillary  system. 

We  have  already  referred  to  the  changes  of  form  caused  In 
the  blood  vessels  by  light. 

Blood  absorbs  light  in  a  high  degree  and  in  quite  a  peculiar 
manner.  This  is  shown  by  the  characteristic  absorption  spec- 
tra In  greenish-yellow  {Hoppe-Seylcr)  and  In  blue-violet 
obtained  by  d'Arsonval')  and  the  author'').  Finsen'^)  laid 
on  one  side  of  the  lobe  of  an  ear  a  piece  of  aristo-paper  and 
directed  a  pencil  of  blue-violet  rays  on  to  the  other  side;  after 
the  lapse  of  5  minutes  under  these  conditions  no  result  was  visi- 
ble on  paper.  When,  however,  the  lobe  had  been  compressed 
between  two  glass  plates,  so  as  to  appear  white  and  bloodless, 
the  paper  turned  black  In  20  seconds.  Whence  we  see  that 
blood,  to  a  considerable  extent,  prevents  the  chemical  rays  from 
penetrating  the  tissues. 

There  Is  especially  one  constitutent  of  blood  which  uni- 
formly absorbs  light,  viz.,  haemoglobin.  Oxyhasmoglobin 
gives  a  different  absorption  spectrum  from  methgemoglobln. 
Quincke'^)  showed  that  haemoglobin  gives  off  its  oxygen  more 
quickly  In  the  light  than  In  the  dark  (the  oxyhcemoglobin  band 


^)   Das    Licht.    Sechs    Vorlesungcn    von    JoJin    Tyndall.      Braunschweig, 
1895,  p.   179. 

^)   Arch,  de  Physiolog.,  XXII,  2,  p.  340. 

')   Cf.  p.  4.30. 

*)  Ueber  die  Bedeutung  der  chem.  Strahlen  des  Lichtes,  Leipzig,  p.  78. 

")  Piiucgcr's  Archiv,  1894,  Vol.  LVII,  p.  134. 


PHOTOTHERAPY  439 

in  the  spectrum  vanishes),  hence  Hght  increases  the  oxidising 
power  of  the  blood  and,  correspondingly,  the  processes  of  oxida- 
tion in  the  human  body. 

We  must  refer  ultimately  to  the  action  of  light  on  the 
capillary  system,  the  pigmentation  left  after  exposure  to 
strong  light,  which  comes  (cf.  p.  419)  from  the  accumulation 
of  hcemosiderin  in  the  interstices  of  the  tissues.  If  this  process 
is  widespread,  /'.  c,  if  this  giving  off  of  blood-colouring  matter, 
in  consequence  of  the  exposure  of  extensive  parts  of  the  body 
to  strong  light,  takes  place  to  a  large  extent,  then  it  causes  a  cer- 
tain impoverishing  of  the  blood  in  elements  and  blood-colouring 
matter,  and  the  body  may  be  stimulated  to  compensate  for  this. 
According  to  this  theory  {Lowenthal  ^) ),  the  influence  of  light 
on  certain  processes  of  metabolism  is  intelligible.  Graffetiber- 
ger^)  holds  that  the  mass  of  haemoglobin  contained  in  the  red 
corpuscles  is  lessened  in  the  dark;  a  diminution  in  the  total  quan- 
tity of  blood  results  from  prolonged  stay  in  darkness.  Marti;'') 
too,  by  means  of  experiments  with  rats,  established  the  fact  that 
deprivation  of  light  lessens  the  number  of  red  blood  corpuscles 
and  to  a  less  extent  the  amount  of  haemoglobin,  whilst  strong 
and  continuous  illumination  stimulates  the  formation  of  erythro- 
cytes and  also  of  haemoglobin  ■*). 

In  accordance  with  the  results  of  these  researches  are  the 
facts  that  the  women  of  the  far  north  are  much  predisposed  to 
amenorrhoea,  and  are  even  said  to  be  quite  free  from  menstrua- 
tion during  the  long  night  of  winter  {Eiilcnbiirg;')  )  whilst  at 
the  close  of  the  Polar  night  the  oxyhaemoglobin  bands  in  the 


')   Deutsche  Medicinalzcitung,   1899,  No.  72. 

=)  Pfluger's  Archiv,   1892,  Vol.  LIII,  p.  238. 

*)  Verh.  d.  Congr.  f.  innere  Med.,  1897. 

*)  P.  Borrisow,  too  (cf.  Zeitschr.  f.  phys.  u.  dirit.  Ther.,  Vol.  V.  p.  237). 
was  unable  to  prove  any  influence  of  either  light  or  darkness  either  on  the 
number  of  the  red  or  the  white  blood  corpuscles,  or  on  the  formation  of 
haemoglobin.  According  to  his  experiments,  the  weight  of  dogs  kept  in  the 
light  increased  considerably,  after  an  initial  decline,  whilst  that  of  dogs  left 
in  darkness  showed  no  increase;  the  former  also  possessed  a  better 
appetite. 

')   Quoted   from  Strchcl,  Die   Verwendung  dcs  Lichtcs  in   der  Therapie, 

p.  8. 


440  RADIO-THERAPY 

blood  of  such  persons  as  were  examined  showed  signs  of  exten- 
sion {Holmgren  and  Gyllenkreiitz^)) . 

Whether  it  is  this  direct  action  on  the  blood  or  stimulation 
of  the  nervous  system  which  again  reacts  on  other  vital  functions, 
stimulating  them,  the  fact  remains  that  under  the  influence  of 
light  the  tissue-change  in  men  and  animals  undergoes  certain 
modifications.  Several  writers  have  cited  interesting  observa- 
tions which  favour  the  second  of  the  two  theories. 

In  the  first  place  we  must  notice  the  important  results 
obtained  by  Quincke,")  who  showed  that  various  tissue-cells 
(blood,  pus,  muscle,  kidneys,  liver,  etc.)  absorb  more  oxygen 
in  the  light  than  in  the  dark.  When  these  substances  were 
mixed  with  subnitrate  of  bismuth,  the  latter  was  reduced,  but 
only  in  the  light.  Severed  muscles  and  nerves,  so  long  as  they 
are  not  quite  dead,  eliminate  carbonic  acid  more  freely  in  the 
light  than  in  the  dark  {Moleschott  and  Fubini ")  ). 

From  these  researches  we  might  then  conclude  that  light 
influences  the  oxidation  of  the  tissues. 

Various  experimenters  claim  to  have  observed  on  many 
occasions  that  matter-change  in  living  animals  and  men  is  thus 
influenced. 

When  light  is  excluded,  dogs,  hens,  pigeons  and  frogs  elim- 
inate less  carbonic  acid  than  in  the  light  {Moleschott,^)  Selmi 
and  Piacentini ''))  \  the  amount  of  carbonic  acid  given  is  in  direct 
ratio  to  the  intensity  of  the  light  {Moleschott)  and  is  not 
dependent  on  the  freer  movement  of  animals  in  the  light 
{Chnssanoiintz  ")  ) . 

With  frogs  and  toads  the  blue  rays  were  most  effective  in 
increasing  the  amount  of  carbonic  acid  given  off;  with  birds  and 


^)   Quoted  from  Gchhard  and  Mocllcr. 

=)   L.  c. 

')  Untersuchungen  zur  Naturlehre  des  Menschen  und  der  Thiere  von 
Moleschott,  1881.  Vol.  XII,  p.  266.  —  Archivio  di  Bozzozero,  1879,  Vol.  Ill 
No.   19,  p.  23,  quoted  from  Ranm. 

*)  Wiener  med.  Wochenschr.,   1885,  No.  43. 

^)  Rendi  conti  del  Reale  Instituto  Lombard  di  sc.  e.  lettre,  1870,  Vol. 
III.  Ser.  II,  p.  51,  ref.  Allg.  med.  Centr.  Ztg.  1872,  p.  810. 

')  Ueber  d.  Einfiuss  des  Lichtes  auf  die  Kohlensaureausscbeidung  im 
thierischen  Organismus.     Inaug.-Dis?crt.     Konigsberg,  1872. 


PHOTOTHERAPY  441 

rodents  the  red  rays  had  most  influence  (Pott^))  .  Fan 
Peck'-)  found  that  beetles (Brunchus  pisi)take  in  more  oxygen  in 
the  light  than  in  the  dark.  Scharling,^)  Pettenkofer  and  Voit*) 
Fubini  and  Roncli'i '')  proved  that  human  beings  give  off  less 
carbonic  acid  in  the  hours  of  the  night  than  in  the  daytime,  even 
with  absolute  rest.  The  two  last-named  writers  confined  their 
researches  to  a  single  limb  (fore-arm  and  hand). 

Brozvn-Scqiiard,  Pfliigcj-  and  others  hold,  however,  that  the 
increase  of  carbonic  acid  elimination  through  light  is  only 
apparent,  being  occasioned  by  the  movement  and  enlargement 
of  the  muscle  with  light  causes. 

S.  Godnezv  *"')  found  that  persons  and  animals  to  whom  day- 
light was  accessible  excreted  more  urine,  urea,  and  chlorides 
than  those  who  stayed  long  in  the  dark.  »S.  DciitscJi  ')  and 
B.  Kogan^)  formed  the  following  conclusions  from  their 
experiments : 

(i)  Red  light  weakens  the  processes  of  both  assimilation 
and  dis-assimilation;  (2)  green  light  stands  lower  than  white, 
in  regard  to  the  accumulation  of  nitrogen,  as  well  as  to  quali- 
tative metamorphoses;  destruction  changes  proceed  more  vigor- 
ously in  green  light;  (3)  yellow  and  violet  light  induce  the  max- 
imum of  energy  in  all  the  vital  processes,  more  complete  meta- 
morphosis prevailing  under  the  influence  of  \'iolet  light;  (4) 
darkness  causes  a  diminution  in  the  exchange  of  nitrogen  in  the 
body  and,  incidentally,  a  diminution  in  the  daily  amount  of 
urine. 


^)  Verglcichende  Unters  iiber  Alengenverhaltcn  d.  ausgcsch.  Kohlensaurc. 
Habilitationsschrift,  Jena   1875. 

^)   Amstcrdamer  IVIaandblaad  voor  natuurwet.  1879.  p.  1 16. 

')   Ann.  dc  chim.  et  de  i)harm.,  1843,  S.  3,  p.  488. 

*)   Bcricht  der  Miinchencr  Akadcniic,  10  November,  1866. 

")   Arch,  per  la  sc.  med.,  1876,  Vol.  I. 

*)  Zur  Lehre  v.  d.  Einfluss  d.  Sonneniiclilcs  auf  die  Tbiere.  Kasansche 
Dissert.,  1882. 

'')  Ueber  den  Einfluss  des  weisscn  Lichtes  iind  dor  verschicdenfarbigen 
Strahlcn  auf  den  Clasaustausch  bei  Warmbliitern.    Petersburger  Dissert.,  i8r)i. 

")  Ueber  den  Einlluss  des  weissen  (elektriscben)  Lichtes  u.  der  ver- 
schiedenfarbigen  Strahlcn  auf  die  Stickstuffnielaniorphose  Ini  Tliieren. 
Petersburger  Dissert.,  1894. 


442  RADIO-THERAPY 

According  to  Godneiv,  Gorbazcwicz,^)  Hammond^)  and 
others,  animals  gain  more  weight  in  light  than  in  darkness. 

The  influence  of  light  on  metabolism  may  be  either  direct 
or  indirect;  it  depends: 

1.  On  the  influence  of  light  on  the  blood  and  the  circulation 
generally.    (See  p.  438.) 

2.  On  the  influence  of  light  on  the  tissue  elements  them- 
selves (cf.  p.  411). 

3.  On  its  stimulating  effect  on  the  nervous  system,  which 
produces  increased  action  of  the  muscles  and  movement  of  the 
body  (Loeb). 

4.  On  the  stimulating  effect  of  light  on  the  organs  of  sense 
(the  eyes),  inducing  increased  or  reflex  energy  in  the  body  func- 
tions. 

In  connection  with  this  dependence  of  the  processes  of  mat- 
ter-change on  the  accessibility  of  the  sensitive  retina  to  light, 
Moleschott,  Bechard,  Selmi  and  Piacentini,  Pott,  Pfliiger  and 
V.  Platten  •')  proved  that  under  the  influence  of  light,  through 
stimulation  of  the  retina,  there  was  marked  increase  in  the  elim- 
ination of  carbonic  acid  and  absorption  of  oxygen. 

Experiments  with  animals,  which  have  been  deprived  of  not 
only  eyes,  but  also  even  of  brain  and  lungs,  furnish  proof  that 
matter-change  may  be  influenced  by  reflex  action  through  the 
skin. 

It  must,  however,  be  stated,  as  opposed  to  the  results  given 
above,  that  papers  have  been  published  denying  light  has  any 
influence  at  all  on  matter-change,  or  assuming  only  quite  a  dif- 
ferent kind  from  that  shown  in  the  experiments  quoted. 

According  to  the  observations  of  Grafenherger*)  and 
others  [Bidder  and  Schmidt).,  the  metabolism  of  carbon  com- 
pounds is  lessened  in  the  dark,  and  more  fat  is  formed  and 
deposited.  Hence,  animals  kept  in  the  dark  Increase  In  weight 
(geese,  for  fattening,  are  kept  In  dark  sheds).      This  retarda- 


^)   Ueber   den   Einflnss   der   verschiedcncnfarbigen    Lichtstrahlen    auf   die 
Entwicklung  n.  das  Wachsthum  der  Saugethiere.     Petersburger  Dissert.,  1883. 
■)  The  Sanitarian,  1873-74,  Vol.  I. 
')  Arch.  f.  d.  gas.  Physiol.,  1875,  XI,  pp.  263,  272. 
*)  Pmigcr's  Arch.,  1892,  Vol.  LIII. 


PHOTOTHERAPY  443 

tion  of  matter-change  In  darkness  enables  starving  animals  to 
live  much  longer  in  the  dark  than  in  the  light  {Jdiicco^)) . 
Bie  -)  does  not  regard  it  in  any  way  as  proved  that  light  influ- 
ences the  amount  of  h.Tmoglobin  in  the  blood,  or  that  it  pro- 
motes the  elimination  of  carbonic  acid. 

Justus  Gaulc^")  claims  to  have  proved  that  with  frogs  m 
winter  time  the  fatty  bodies  lying  next  to  the  sexual  organs  dis- 
appear in  the  day  time  and  are  formed  again  at  night,  and  this 
in  the  case  of  blinded  frogs  as  well,  which  shows  that  light  acts 
on  the  fatty  bodies  through  the  skin. 

It  has  been  assumed  by  many  that  light  influences  tJic 
breathing,  the  temperature  of  the  body  and  the  pulse. 

Fere*)  found  in  one  case  that  respiration  was  19  to  the 
minute  in  yellow  light,  17  In  green,  and  only  15  In  red.  Under 
the  Influence  of  red  light  the  pulse  becomes  fuller  and  slower; 
In  darkness  it  falls  so  greatly  that  the  sphygmograph  ceases  to 
show  oscillation. 

/.  Godnew,^) -too,  found  that  the  number  of  heart  beats  and 
the  rate  of  breathing  Increased  noticeably  whilst  the  animals 
on  which  he  was  experimenting  were  under  Illumination. 

Triwus^)  made  researches  under  the  guidance  of  W.  v. 
Bechterew  into  the  influence  of  coloured  light  on  the  pulse  of 
healthy  persons.  Mosso's  plethysmograph  was  mainly  used  in 
the  measurements.  The  subjects  were  usually  kept  about  two 
hours  In  the  special  coloured  room  of  the  clinical  hospital.  The 
plethysmograms  were  taken  at  the  beginning  and  end  of  each 
experiment.  In  most  cases  the  coloured  light  caused  depres- 
sion of  the  pulse,  i.  e.,^\t  became  less  rapid  and  less  full.  \'iolet 
Is  the  most  depressing  colour,  and  red  the  least;  the  action  of 
the  other  colours  correspond  with  their  place  in  the  spectrum, 
with  the  exception  of  yellow,  which  had  no  effect,  probably 
because  the  yellow  plates  let  through  nearly  all  the  rest  of  the 


^)  Communica/.onc  all'   Acad,   di   Torino,  quoted  in  Fraiilccnliiiuscr. 

')  20.  Congr.  f.  innere  Mcdicin,  IQ02. 

»)  Centralbl.  f.  Physiol..  1900.    Vol.  XIV,  p.  25. 

*)  Degenerescence  et  criniinalitc,  1888,  quoted  in  K'aicin. 

')  L.  c. 

")  Wissensch.     Sitszung.  der  Vereinigung    dor    Aerzte    d.     Petersl)iu-gcr 

Klinik  f.  Nerven-  und  Qeisteskrankli.,  Jrui.  2j\b,  1900.     Quoted  in  Dicorctcky. 


444  RADIO-THERAPY 

light  rays.  Triwiis  surmises  that  every  coloured  light  ray 
forming  in  itself  only  one  part  of  the  energy  of  the  united  white 
stream  of  light  necessary  for  the  physiological  nerve-tone,  we 
must  look  upon  coloured  light  as  a  peculiar  form  of  light-hun- 
ger, which  produces  a  certain  minus  in  the  chemistry  of  the  ani- 
mal body.  That  is  to  say,  that  the  effect  of  any  one  colour  may 
be  explained,  not  by  its  own  action,  but  by  the  absence  of  that  of 
all  the  rest  of  the  spectrum. 

It  is  well  known  that  sun  baths  and  light  baths  affect  the 
pulse  and  respiration,  as  well  as  the  temperature,  raising  all  con- 
siderably if  the  exposure  is  prolonged.  In  these  cases,  how- 
ever, it  would  seem  to  be  rather  the  radiating  heat  than  the 
radiating  light  which  is  felt,  though  the  latter  may  possibly  have 
some  share  in  the  result.  Raum  is  inclined  to  ascribe  to  light 
some  influence  on  the  daily  fluctuations  of  temperature,  conver- 
sion of  matter  and  excretion  in  human  organisms,  both  healthy 
and  sick. 

It  is  evident,  from  many  biological  facts  already  adduced, 
that  light  has  a  powerful  influence  on  the  Jiervous  system  and 
the  organs  of  sense.  We  see  it  not  only  in  the  action  on  the 
nervous  organs,  on  consciousness  and  the  mental  condition,  but 
also  in  the  many  phenomena  and  modifications  of  vital  functions 
arising  from  its  indirect  action.  The  various  rays  of  the  spec- 
trum have  a  striking  influence  on  men  and  beasts.  Goethe,  in 
his  "Theory  of  Colours,"  called  attention  to  the  connection 
between  colours  and  certain  emotions.  No  natural  phenome- 
non affects  the  mind  of  man  more  deeply,  no  force  is  more 
stimulating  to  his  mental  powers,  than  the  change  from  dark- 
ness to  light  or  vice  versa.  Ponza  found  by  experiments  with 
those  mentally  affected  that  blue  has  a  soothing,  red  an  exciting 
effect. 

We  know  that  light  gives  rise  to  movements  by  reflex  action, 
not  only  by  direct  action  on  the  tissues  of  animals.  Dogel  and 
Jegorozv  ^)  found  that  the  circulation  of  the  blood,  both  in  men 
and  dogs,  was  very  markedly  changed  by  the  action  of  green 


^)   Quoted  from  Dzvnrclzhv's  Rcf.,  Zeitschri.  f.  di;it.  u.  physik.  Then,  Vol. 
V,  p.   165. 


PHOTOTHERAPY  445 

light  irritating  the  eye.  It  was  proved  that  matter  change 
may  be  affected  retiexly  by  means  of  the  skin  and  the  eye. 
P.  Bert  ')  found  that  a  chameleon,  blinded  in  one  eye,  became 
paler  in  colour  in  the  whole  corresponding  side  of  the  body. 
In  the  case  of  other  animals  {c.  o.,  the  octopus)  it  can  also  be 
prov^ed  that  light  affects  the  colour  of  the  skin  rcHexly. 

Light  has  a  powerful  effect  on  other  nervous  organs  also. 
We  need  only  point  to  the  simple  and  never  failing  experiment 
of  causing  violent  sneezing  by  light.  No  doubt  this  comes 
through  the  medium  of  the  nerves,  distributed  amongst  the  con- 
junctiva (trigeminus),  for  the  inclination  to  sneeze  caused,  or 
immensely  increased,  by  blinking  at  the  sun,  may  be  at  once 
repressed  by  closing  the  eyelids  tight,  so  that  the  chemically- 
Irritant  rays  may  be  excluded  by  the  lid.  But  since  a  good  deal 
of  red  still  comes  through  the  lid  (as  we  perceive  when  we  turn 
to  the  sun  with  closed  eyes)  we  must  assume  that  it  is  the 
so-called  chemical  rays  which  set  up  the  reflex  action  of  sneez- 
ing. Inclination  to  sneeze,  which  soon  produces  actual  sneezing, 
is  felt  at  once  when  the  eyelids  are  opened  a  little  after  a  while. 

We  may  ascribe  also  modifications  in  the  functions  of 
internal  organs  to  reflex  and  transferred  action  of  light.  Sev- 
eral writers  (Holzknccht,-)  Bie^))  have  maintained  quite 
recently  that  we  have  here  only  indirect  light  action,  since  the 
so-called  chemical  rays,  which  are  effective,  are  completely 
absorbed  by  the  organs  on  the  surface  of  the  body. 

Holzknccht  for  this  reason  regards  all  light  treatment  of 
internal  diseases  as  perfectlv  useless.  He  even  docs  not  hesitate 
to  assert  that  there  is  not  and  cannot  be  any  curative  action  of 
rays  below  the  surface,  that  there  neither  is  nor  ever  will  be  any 
kind  of  irradiation  available  for  the  cure  of  deep-seated  disease, 
for  any  irradiation  which  is  cffecti\'e  deep  down  must  at  the 
same  time  destroy  the  upper  layers  of  tissue. 

Tlie  author  himself  would  not  pronounce  so  confident  an 
oj)ini()n.       We   do   certainly   know   that   the   ultra-violet   rays, 


')  L.  c. 

*)    K.  k.  Gcscllsch.  (\.  Acr/lo,  \\'iiii.  Vch.  21st,  igo2. 

')  L.  c. 


446  RADIO-THERAPY 

which  have  decided  effect  on  living  tissue,  are  largely  absorbed 
in  the  uppermost  layers  of  the  skin. 

But  we  know  also  that  the  blue  and  violet-rays  (which  are 
likewise  very  effective  physiologically  (cf.  p.  407),  penetrate 
more  deeply  than  the  ultra-violet,  and,  indeed,  if  the  light  is 
powerful  and  the  duration  of  exposure  prolonged,  make  their 
way  to  relatively  deep-lying  layers,  where,  without  destroying 
the  superficial  layers,  they  produce  powerful  effects  {e.  g.,  on 
lupus  nodules  in  the  cutis). 

It  is  further  known  that  the  penetrating  power  of  rays  (into 
animal  tissue)  increases  in  proportion  to  the  wave-length, 
that,  t'.  g.,  red  light  pierces  relatively  large  masses  of  tissue 
{e.  g.,  the  hand)  in  sufficient  quantities  to  reach  greater  depths. 
It  is  by  no  means  proved  that  these  rays  have  absolutely  no 
physiological  effect;  we  only  know  that  they  do  not  act  on  the 
skin  in  the  same  way  as  the  blue,  violet  and  ultra-violet  rays.  It 
is,  however,  just  possible  that  these  ravs  affect  other  tissues;  do 
we  not  know  that  certain  constituents  of  the  body  (e.  g.,  blood) 
have  a  quite  specific  power  of  absorption  for  them?  and  accord- 
ing to  a  law  of  nature,  which  holds  good  throughout,  every 
energy  that  is  absorbed  must  be  in  some  way  effective.  Neither 
are  the  red,  yellow  and  green  rays  so  chemically  ineffective  as  Is 
often  assumed.  On  the  contrary,  it  has  been  proved  that  they 
have  a  far  more  powerful  effect  on  certain  substances  than  the 
rays  of  shorter  wave-length,  c.  g.,  on  dilute  solutions  of  nitro- 
prusside  of  sodium  with  sulphide  of  ammonia,  on  the  brown 
peroxide  of  lead  produced  by  oxidation  from  protoxide  of  lead 
under  violet  light,  on  green  vitriol,  on  metallic  arsenic  and  arsen- 
lous  acid,  on  sulphuretted  hydrogen,  sulphide  of  sodium,  on 
cyanine,  and  on  certain  plant  pigments,  chlorophyll,  etc.  We 
know  from  the  biology  of  plants  how  important  these  rays  are 
for  growth  and  nutrition.  We  ought,  in  the  author's  opinion, 
not  to  pronounce  against  the  possibility  of  any  biological  action 
of  these  rays  until  after  purely  negative  results  have  been 
yielded  by  the  most  careful  in\estigations,  with  prolonged  and 
intense  illumination  of  the  various  kinds  of  tissue  with  all  the 
classes  of  rays  here  concerned. 

It  would  seem  that  such  in\estigations  might  not  be 


PHOTOTHERAPY  447 

entirely  fruitless.  According  to  L.  Camus,^)  the  col- 
ouring matter  in  dog's  gall  is  quickl\-  oxidised,  turning 
green  and  then  losing  its  colour,  in  the  presence  of  oxy- 
gen by  the  action  ot  light,  fhe  serum  of  horse's 
blood,  too,  becomes  first  green  and  then  loses  colour, 
when  it  is  kept  accessible  to  oxygen  with  access  of  light. 
Summing  up  this  last  chapter  we  may  say  that  light  has  the 
following  effects : 

1.  It  has  an  irritant  effect  on  the  skin,  producing  intlamma- 
tion. 

2.  It  promotes  perspiration. 

3.  It  has  a  direct  effect  on  the  blood  and  the  blood  vessels. 

4.  If  large  portions  of  the  body  are  exposed  to  strong  light, 
It  causes  a  considerable  rush  of  blood  to  the  surface  and  thereby 
depletion  of  the  internal  organs. 

5.  It  modifies  directly  or  indirectly  the  transmutation  of 
matter. 

6.  It  incites  movement. 

7.  It  exercises  influence  on  the  nervous  system  and  the  mind. 

8.  It  has  paraslticidal  powers. 

9.  Excess  of  light-stimulus  is  destructue  and  paralyzing 
(causing  dermatitis,  long-lasting  erythema,  tendency  to  recur- 
rence of  the  same,  etc. ) . 

The  Therapeutic  Use  of  lJ<iht. 

§  57.  The  beneficial  therapeutic  action  of  light  has  been 
known  instinctively,  as  we  may  say,  for  a  long  time.  For 
example,  in  China,  Japan,  Mexico  and  Haiti,  methods  have 
been  followed  In  medicine  which  take  direct  account  of  the 
helpful  or  deleterious  power  of  sunlight;  in  some  cases  patients 
were  given  sun-baths.  In  others  kept  from  the  light. 

According  to  /.  Marciise,'-)  the  old  (ireeks  were  accus- 
tomed, on  grounds  of  both  pleasure  and  health,  to  expose  them- 
selves (without  clothing,  and  having  first  anointed  themselves) 
to  the  sunshine  on  the  flat  roofs  of  their  houses.  Vestric'uis 
and  (yiccro  tell  us  that  the  Romans  In  the  same  way  took  sun 


')    C.  R.  Soc.  dc-  l)iolog..  W-h.  271I1,  rS(;7. 

^)   Zcitschiift  f.  diat.  itnd  pIiy-~.  'I'luTapic   \'(.l.   111.  p.  ^^,6. 


448  RADIO-THERAPY 

baths,  followed  often  by  a  cold  sponge-bath.  In  later  days 
they  had  special  outbuildings  (Solaria)  where  the  Heliosis  was 
taken.  Herodotus  made  special  mention  of  sun-baths  for 
persons  with  poor  or  enfeebled  muscles.  Antylliis  described 
more  precisely  the  effects  of  insolation  (erythema,  profuse  per- 
spiration), and  gave  lengthy  descriptions  of  the  action  of  these 
sun-baths  (loss  of  fat,  lessening  of  swellings,  improvement  in 
cases  of  dropsy,  general  bracing,  good  effect  on  respiration). 
The  diseases  for  which  he  recommended  them  are :  Dropsy, 
sciatica,  affections  of  the  kidneys,  elephantiasis,  "swellings," 
abdominal  affections,  chronic  diseases  of  the  bladder,  paralysis, 
uterine  diseases  and  fluor  albus. 

Herodotus  and  C.  Aureliau,  also  Antylliis,  recommended 
light-baths  in  cases  of  skin  disease. 

Heliosis  was  in  those  days  also  the  treatment  for  arthritis, 
nerve  complaints,  colic,  jaundice,  atrophy  and  constitutional 
anomalies  in  children.  The  sun-bath  was  used  not  only  gen- 
erally but  locally,  e.  g.,  as  preparative  for  blistering.  Light- 
baths  and  water-baths  were  often  combined  {Vittriivhis,  Pliny). 

In  the  Middle  Ages  this  method  of  treatment  passed  into 
oblivion.  Facts,  indeed,  were  known  as  to  both  the  good  and 
the  evil  effects  of  sunshine  on  the  body,  but  we  hear  nothing  of 
systematic  light  treatment  before  the  beginning  of  the  last  cen- 
tury. At  that  time  the  Jena  professor,  Lobel,  gave  a  precise 
account  of  the  indications  and  contra-Indications  for  the  light 
treatment  of  sick  persons,  and  described  a  special  apparatus 
for  sun-baths  (  ri'^iodEi'jxcg  )  which  was  to  be  used  "in  vari- 
ous diseased  conditions.  The  medical  literature  of  the  19th 
century  from  that  time  on  records  a  series  of  investigations 
which  we  must  regard  as  the  basis  and  forerunners  of  the  mod- 
ern light  treatment.  In  the  first  rank  we  must  place  the 
researches  of  the  numerous  bacteriologists,  who  hav^e  proved  the 
parasiticidal  action  of  light,  and  have  determined  to  which  part 
of  the  spectrum  this  is  specially  due.  Then  come  the  physio- 
logical works  of  Hammer,  Uldnicirk  and  others  (mentioned  on 
pp.  420,  422)  on  the  different  action  on  the  skin  of  the  red  and 
the  blue  end  of  the  spectrum,  and  Moleschott's  on  metastasis. 
We  find  in  the  beginnings  of  chromo-therapy  in  Ponza,  Charpig- 


PHO  TO  THERAPY  449 

non,  Martin,  Veiel,  Unna,  Berliner,  JFolters,  and  of  so-called 
negative  light-therapy  in  Piorry,  Picton,  Black,  Barlozv  and 
Waters.  We  see  attempts  to  substitute  electric  light  for  sun- 
light (L^/r;«rt«;/),  to  use  concentrated  light  in  the  treatment  of 
lupus  (  Thayer,  Oiterbeiu,  Mehl) .  We  find  the  methods  of  light- 
decomposition  (heat  and  light  filters),  long  used  In  physics  and 
photo-chemistry,  now  turned  to  account  in  researches  into  the 
physiological  action  of  light  on  the  skin  (IFidmark) .  Kelogg's 
works  on  the  effects  of  electric  incandescent  baths  gave  a  pow- 
erful Impetus  to  the  study  of  light  In  Its  bearing  on  medicine, 
and  mark  an  important  stage  In  its  development. 

None,  however,  has  done  such  work  for  the  furtherance  of 
light-therapy  as  Finscn  (from  1893  onwards).  He  first  made 
careful  experiments  of  his  own,  and  tested  thoroughly  those  of 
others,  and  then,  having  laid  a  sound  theoretic  basis,  he  con- 
structed the  apparatus  by  which  he  was  able  to  prove  the  use- 
fulness of  light  when  applied  In  its  most  intense  form  to 
malignant  growths,  such  as  lupus.  Finsen  was  In  the  happy 
position  of  being  able  to  go  on  his  way  unhampered  by  external 
circumstances;  help  came  to  him  from  private  individuals  and 
from  the  State,  and  he  was  thus  enabled  to  carry  his  plans  to 
completion  and  in  a  comparatively  short  time  to  demonstrate 
forcibly  to  the  medical  world,  by  results  with  an  enormous 
number  of  patients,  the  extraordinary  value  of  the  light  treat- 
ment. We  owe  It  no  doubt  to  this  circumstance  that  light- 
therapy  has  made  such  strides  within  a  comparatively  brief 
period. 

We  may  reasonably  hope  that  the  near  future  will  clear  up 
many  a  doubtful  point  and  widen  the  range  of  photo-therapy; 
for  many  other  workers  are  busy  in  the  field.  Bang,  Strebel, 
Gorl,  Foveau  dc  Coiirmelle,  Lorlet  and  Gcnaud  have  pub- 
lished interesting  work  on  the  possible  simpli tying  of  the  appa- 
ratus and  the  strengthening  of  Its  effect;  Moeller,  Strebel,  Gle- 
boivsky,  the  present  writer,  and  others,  are  seeking  by  theoretic 
researches  to  solve  certain  Important  problems  In  light-therapy, 
and  the  practical  results  of  light-treatment  on  most  diverse  dis- 
eased conditions  are  at  the  present  day  being  studied  with  the 
greatest  zeal. 


450 


RADIO-THERAPY 


Light  may  be  used  for  therapeutic  purposes  either  as  natural 
or  as  artificial  light;  /.  e.,  either  without  being  decomposed  and 
collected  or  as  broken  up  into  its  component  parts  and  concen- 
trated. 

{a)   Treatment  with  Sunlight. 

§  58.  The  sun  is  our  most  natural  source  of  light.  Even  in 
our  latitudes  on  bright  clear  days  it  is  the  most  powerful  light 
source  which  we  possess. 

This  may  be  seen  by  the  following  scale  (from  Picker- 
ing^)): 


Light-giving  Power  in  the  Several 
Parts  of  the  Spectrum 

Total  Light- 
Power 

expressed  in 
Normal 
Candles 

C 
Red 

D 
Yellow 

C 

no. 

Blue 

White  light 

Gas  lamp 

Lime  light 

Electric  arc  light. 
Magnesium  light. 

Moonlight 

Sunlight 

73 

74 

59 
61 

50 
87 
45 

100 
100 
100 
100 
100 
100 
100 

104 
103 

113 
121 
223 

155 
250 

134 

125 
285 

735 
1,129 

?,(^?> 
2,971 

I 
16 

90 
362 

215 
204 

70,000 

Unfortunately,  as  regards  our  use  of  this  source  of  light, 
we  are  dependent  not  only  on  weather,  but  also  on  other  cir- 
cumstances which  affect  chemical  intensity  as  well  as  its  optical 
brightness.  As  long  ago  as  1866,  Roscoe  and  Baxendeli,  follow- 
ing Eder-)  (from  whose  standard  work  we  have  taken  these  and 
the  following  data),  proved  that  the  chemical  intensity  of  light 
does  not  by  any  means  coincide  with  optical  brightness.  The 
chemical  light-intensity  of  the  sun's  rays  varies  with  the  time  of 
day  and  season  of  the  year;  that  is  to  say,  with  the  sun's  height 
in  the  heavens.  The  maximum  intensity  is  found  when  the  sun  is 
at  its  highest,  /.  e.,  at  midday.  In  summer  the  chemical  action 
both  of  the  sun  and  of  the  blue  light  of  the  sky  is  distinctly 
more  powerful  than  in  winter;  thus,  for  instance,  at  Vienna  the 


')   Ausfiihrl.  Handbuch  d.  Photographie,  Vol.  I,  pp.  320  ff. 

*)   From  Edcr's  Ausfiihrl.  Handbuch  d.  Photographie,  I,  p.  355. 


PHOTOTHERAPY  451 

intensity  of  the  sunlight  even  at  midday  in  December  is  only 
about  as  great  as  it  is  at  six  o'clock,  either  morning  or  evening, 
in  June.  The  chemical  intensity  of  light  is  weakened  in  spring. 
The  optical  intensity  of  sunlight  is  weakened  by  about  one- 
fourth  during  its  passage  through  the  atmosphere.  The  chem- 
ically active  rays  lose  very  much  more.  Lan^ley  found  that  the 
following  percentage  of  the  various  classes  of  rays  passed  the 
atmosphere  ^ : 


Ultra-violet 

39  per  cent, 

Violet 

42 

Blue 

48 

Greenish  blue 

54 

Yellow 

63 

Red 

70 

Infra  red 

76 

According  to  E.  v.  Oppolzcr,-)  the  atmosphere  absorbs 
about  20  per  cent,  of  the  optical  rays  and  about  30  per  cent,  of 
the  photographic  rays.  C.  Masch  "')  proved  that  57.5  per 
cent,  of  the  sun  rays  acting  on  bromide  of  silver  are  lost  by 
extinction  in  the  atmosphere. 

The  extent  to  which  the  air  absorbs  the  light  is  thus  con- 
siderable; it  varies  with  the  amount  of  vapour,  carbonic  acid 
and  suspended  dust  present  in  the  air,  also  with  its  movement 
and  temperature.  By  the  atmospheric  movement,  layers  of 
varying  density  are  formed,  and  the  intensity  of  the  light  rises 
with  the  temperature. 

The  chemical  intensity  of  sunshine  increases  considerably 
as  one  rises  into  the  higher  regions  of  the  air,  i.  e.,  as  the  atmos- 
pheric pressure  becomes  less;  thus  Simony  found  that  the  ultra- 
violet spectrum  of  sunlight  extended  much  further  towards  the 
more  strongly  refrangible  end  on  the  summit  of  the  Pic  de 
Teyde   on   Teneriffe    (3,500   metres   high)    than    in   the   plain 


')   For  further  information  see  /.  M.  Pcrnter,  Metcorolog.  Optik,  Vienna, 
1902;  also  /.  Wicsncr,  Studicn  iibcr  das  ijhotocliem.  Klinia.     Wiener  Akad. 
*)   Sitzungsbericht  d.  K.  Akad.  d.  Wissensch.  107,  Part   II,  \).   1477,  i8y8. 
*)    Schriftcn  d.  Naturw.  Ver.  f.  Schlcszvi^-H olstcin,  Vol.  XII,  II.  2. 


452  RADIO-THERAPY 

below.      There  differences  are,  however,  slight  compared  with 
those  dependent  on  geographical  latitude. 

Corresponding  to  the  course  of  the  sun,  which  up 
to  the  latitude  of  about  23     passes  the  zenith  twice  in 
the  year,  there  are  within  these  latitudes  two  maxima  of 
light-stretch,  in  March  and  September  at  the  equator, 
in  April  and  August  at  lat.    10°.    At  lat.  20""  there  is 
only  one  maximum,  but  that  lasts  from  May  to  July. 
The   nearer  we  approach  to   the  higher  latitudes   the 
more  sharply  do  we  find  the  curve,  which  denotes  the 
distribution  of  light  during  the  year,  rising  towards  the 
maximum     in    the     summer    months.       The     absolute 
amount  of  light  given  off  by  the  sun  to  the  earth  in  the 
course  of  a  day  is  greatest  at  the  equator  and  the  lower 
latitudes;     it    lessens     towards    the     higher    latitudes. 
There  is  only  one  irregularity  in  this  respect,  i.  e.,  in  the 
highest  latitudes  of  all,  where  the  sun  does  not  set  dur- 
ing the  whole  Arctic  summer.    (From  D.  Spitaler^)). 
Holetschck  estimates  the  chemical  intensity  of  diffused  day- 
light at  mid-day  in  winter  as  one-half  in  the  summer,  as  only 
one-quarter,  of  that  of  direct  sunlight.    In  summer  the  morn- 
ing and  evening  direct  sunlight  has  still  about  double  the  chem- 
ical intensity  of  diffused  daylight,  but  in  winter  there  is  a  very 
slight  difference  between  the  two.      According  to  Roscoe  and 
Baxendill,  the  ratio  of  the  chemical  intensity  of  direct  to  that 
of  diffused  sunlight  is  not  constant  for  a  given  height  of  the 
sun  in  different  places,  but  varies  with  the  transparency  and 
other  conditions  of  the  atmosphere. 

Naturally,  the  chemical  intensity  of  daylight  is  much  influ- 
enced by  the  condition  of  the  clouds,  c.  g.,  by  the  depth  and 
density  of  the  layers  of  cloud  and  the  colouring,  shape  and  posi- 
tion of  the  clouds  relative  to  the  sun.  Mist  and  clouds  lessen 
the  chemical  intensity  far  more  than  our  subjective  sensations 
of  light  would  lead  us  to  believe. 

Simple  sunlight  is  used  therapeutically  in  sun-baths  and  light- 
and  air-baths.     Single  filtered  components  of  the  spectrum  are 


')   Eder's  Jahrh.  f.  Photogr.,  1888,  2  Jahrg.,  p.  379. 


PHOTOTHERAPY  453 

used  In  so-called  chromo-therapy.  In  a  concentrated  form,  either 
without  being  decomposed,  or  after  abstraction  of  certain  com- 
ponents (the  heat  rays),  it  is  used  in  the  treatment  of  skin 
diseases. 


Siin-Baths. 

§  59.  Patients  taking  sun-baths  ^)are  usually  placed  on  rugs 
or  mattresses,  with  the  head  raised  and  protected  from  the  wind. 
In  a  v'erandah  entirely  open  to  the  south.  The  head  and  eyes 
are  protected  from  the  direct  rays  by  dark  glasses  and  suitable 
shades. 

Sun-baths  are  taken  In  the  height  of  summer  between 
10  a.  m.  and  5  p.  m.;  beginning  with  at  least  a  quarter  of  an 
hour,  the  time  Is  usually  increased  to  three-quarters,  seldom  to 
more  than  an  hour.  During  the  bath  the  position  is  changed 
at  intervals,  so  that  the  rays  may  fall  on  all  parts  of  the  body; 
the  same  position  Is  maintained  until  violent  perspiration  breaks 
out  on  the  exposed  part,  but  not  for  longer,  or  too  violent  inflam- 
matory reaction  might  result. 

After,  and  possibly  even  during  the  sun-bath,  a  quick  bath 
(of  either  the  whole  body  or  parts)  at  72°  to  82°  is  recom- 
mended. After  this  the  patient  Is  rubbed  down  and  at  the  same 
time  massaged,  unless  there  are  symptoms  which  make  this  not 
advisable.  Many  doctors  order  a  dry  pack  of  a  quarter  of  an 
hour  after  the  sun-bath.  When  the  bathing  Is  done  the  patient 
takes  exercise. 

The  sun-baths  are  sometimes  taken  every  day,  but  usually 
only  2  or  3  times  a  week.  Persons  In  health  would  find  one  a 
week  sufficient. 

As  direct  effects  of  sun-baths,  besides  the  erythemous  reac- 
tion of  the  skin  (In  appearance  like  a  scarlet- fever  rash),  leading 
to  Intense  pigmentation  and  subsequent  desquamation,  may 
be  mentioned  profuse  perspiration,  rise  In  temperature  to  40°  C. 
in  the  case  of  sensitive  persons,  nervous  disturbances,  and  with 
healthy  persons  a  pleasant  feeling  of  refreshment  and  comfort. 


')    For  incandescent  light  baths,  see  pp.  366  ff. 


454  RADIO-THERAPY 

The  appetite  is  improved,  and  the  patient  feels  cheerful  and 
often  very  sleepy. 

Sun-baths  are  said  to  be  beneficial  in  disorders  of  nutrition 
(obesity,  diabetes,  gout),  in  scrofula,  rickets,  some  diseases  of 
the  internal  organs  (asthma,  heart-disease),  anaemia,  cachexy, 
nervous  affections  (neuralgia,  neurasthenia,  sciatica),  affections 
of  the  skin  and  mucous  membranes. 

The  beneficial  effects  of  sun-baths  are  due  to  their  action  in 
promoting  perspiration  (for  the  sweat  eliminates  harmful 
matter  from  the  body),  and  also  to  the  stimulation  of  meta- 
bolism and  of  the  nervous  system  by  light,  and  to  the  direct 
action  of  light  on  the  blood.  The  violent  prolonged  hyper- 
aemia  of  the  skin  induces  a  determination  of  blood  from  the 
internal  organs  to  the  surface  of  the  body,  and  thereby  the 
depletion  of  these  organs. 

The  bactericidal  action  of  sunlight  does  not  count  for  much 
here,  as  the  ultra-violet  rays  (which  are  most  effective  in  that 
respect)  have  little  penetrating  power.  The  blue  and  violet 
rays,  however,  penetrate  more  deeply,  and  their  anti-bac- 
terial action  is  not  to  be  disregarded. 

On  the  other  hand,  light  promotes  the  general  power  of 
assimilation.  The  more  vigorously  this  goes  on,  the  greater, 
according  to  Liehermeister,  will  be  the  vital  energy  of  the  body 
and  its  power  of  resistance  to  everything  injurious,  especially  to 
pathogenic  micro-organisms.  This,  as  well  as  the  hyperaemia 
induced  in  limbs  exposed  to  irradiation  for  a  long  time 
(2  or  3  hours  daily),  may  explain  the  cures  reported  by  Ck- 
chansky,^)  Poncet,-)  Perdu  and  Blanc,^)  in  cases  of  local  tuber- 
culosis in  joints  and  bones. 

As  a  substitute  for  sun-baths  in  the  open  air,  Riedcr  in  the 
cold  season  orders  sun-baths  within  doors — or  electric  arc-light 
baths. 

Light-  and  Air-Baths. 

§  60.  In  these  baths  the  patients  move  about  in  the  open  air, 
•vith  little  or  no  clothing,  for  a  period  of  from  2  to  6  hours.  To 


^)   Gesellsch.  d.  Kinderartze,  Moscow,  March  7th,  1901. 

')  Millioz,  These  de  Lyon,  1899. 

")   Revue  intern,  de  I'electrotherapie,  Jan.,  igoo,  p.   157. 


PHOTOTHERAPY  455 

keep  themselves  warm  they  do  some  manual  work  or  gymnas- 
tics, or  have  massage.  Light-  and  air-baths  are  taken  morning 
and  evening,  with  a  sun-bath  or  hot-bath  at  midday. 

According  to  Ricder,  the  effective  factors  with  these  baths 
are  the  thermal  stimulus,  the  increased  activity  of  the  skin 
through  the  radiation  of  heat,  and  the  influence  of  light  on 
metabolism. 

Light-  and  air-baths  are  used  as  a  general  tonic  for  bracing 
the  nervous  system,  for  treating  obesity,  in  cases  of  congestion 
of  internal  organs,  and  to  stimulate  the  action  of  the  heart  and 
kidneys.     Their  effects  are  similar  to  those  of  the  "water-cure." 

Chrovw-Tlierapy. 

§61.  Coloured,  that  is  filtered,  white  sun-light  in  a  non- 
concentrated  state  has  been  hitherto  used  in  the  treatment  of 
infectious  general  diseases  (small-pox,  measles,  scarlatina, 
erysipelas),  nervous  affections  and  a  few  skin  diseases. 

General  chromo-therapy  is  applied  by  keeping  the  patient 
continuously,  for  some  time,  in  a  room  to  which  light  is  only 
admitted  through  suitably  coloured  glass  (red  or  blue). 
Chromo-therapy  is  applied  to  local  affections  by  wrapping  the 
diseased  part  of  the  body  closely  in  suitably  coloured  stuffs, 
which. serve  as  light-filters. 

Our  experience  so  far  leads  to  the  conclusion  that  the  treat- 
ment of  localised  skin  affections  with  red  diffused  light  leads 
to  good  results. 

According  to  Finsen^^)  chromo-therapy  was  first  success- 
fully employed  in  the  popular  medical  practice  of  past  centuries. 
Thus  in  China,  Japan  and  Roumania  the  face  and  hands  of 
small-pox  patients  were  swathed  in  red  cloths,  and  graver 
symptoms  thereby  averted.  The  first  experiment  in  chromo- 
therapy  on  a  scientific  basis  was  made  in  1887  ^Y  ^'^^-  ^'^^'i^'l, 
who  cured  violent  persistently  recurring  eczema  solare  in  the 
case  of  a  lady  by  ordering  the  use  of  red  silk  veils.-) 


')   Uebcr  die  Bcdcutung  dcr  cIkiii.  Slrahkn  (r-s  [Jclilcs,  etc.    Leipzig,  1899. 
')  Vierteljahrschr.  f.  Derm,  und  Syph.,  1897,  p.  1113. 


456  RADIO-THERAPY 

Walters,'')  Unna-)  and  Berliner  "")  reported  similarly  good 
results  in  1892.  Instead  of  the  red  light  filters,  Unna  and 
Berliner  used  yellow  (coloured  with  curcuma)  masks,  veils  and 
windows. 

Quite  recently  fF.  JVinternitz*)  has  reported  similar 
results  in  the  case  of  affections  not  in  any  way  traceable  to 
light  action.  By  covering  up  with  red  materials  the  parts  of 
the  body  exposed  to  the  sun,  he  has  diminished  chronic-hyper- 
semia  of  the  skin  and  improved  and  cured  eczema;  and  by  the 
same  means  he  has  brought  about  distinct  improvement  in  cases 
of  chronic  rheumatic  affection  of  the  joints,  hands  and  feet. 

Acute  exanthemata  were  first  treated  by  chromo-therapy  by 
Niels  Finsen'')  in  July  1893.  As  long  ago  as  1832  Picton'') 
observed  that  light  had  an  unfavorable  effect  on  the  course  of 
small-pox,  and  Piorry  ')  came  to  the  same  conclusion  in  1848. 
Communications  to  the  same  effect  are  frequent  in  medical  liter- 
ature. Barlow^)  and  Waters^)  therefore  excluded  all 
light  from  their  small-pox  patients,  and  they  found  that  this 
treatment  resulted  in  the  drying  up  of  the  pocks  without  suppu- 
ration or  scars. 

Finsen  noticed  that  persons  recovered  from  small-pox  have 
the  deepest  and  most  numerous  scars  on  the  face  and  hands,  i.  e., 
on  those  parts  most  exposed  to  light.  Taking  into  account  his 
own  experiences  and  those  of  others,  Finsen  surmised  that  the 
so-called  chemical  rays,  whose  injurious  effect  on  the  skin  had 
been  proved,  represent  an  etiological  factor  in  the  suppuration 
of  the  lesions.  On  this  assumption  he  treated  his  small-pox 
patients,  as  Veiel  had  done  before  him  in  the  case  of  eczema 
solare,  with  red  light,  i.  e.,  he  kept  them  in  a  room  from  which 
the  chemical  rays  were  excluded.     This  treatment,  according 


^)  Erganzungsh.  z.  Arch.  f.  Derm.  u.  Syph.,  1892,  I,  p.  187. 

^)  Monatsh.  f.  prakt.  Derm.,  1885,  Vol.  IV,  p.  277. 

')  Ibid.  1890,  Vol.  XI,  Nos.  10  and  11. 

*)  22.  offentl.  Vers.  d.  balneol.  Gesellsch.,  Berlin,  May  7-12,  1901. 

")  L.  c. 

*)  Arch.  gen.  de  med.,  XXX,  p.  406. 

'')  Traite  de  medecine  pract.,  T.  VII,  p.  495. 

')  The  Lancet,  1871,  p.   I. 

')  Ibid.  1871,  p.  151. 


PHOTOTHERAPY  457 

to  the  reports  of  Lindholm,  Sucndsen,  Feilberg,  Strand^a^aard, 
Benckert,  Krohn,  Mygind  and  others,^)  results  in  the  total  or 
partial  suppression  of  suppuration  and  Its  concomitant  fever, 
and  the  absence  of  scars.  Such  scars  as  are  left  are  mostly 
only  superficial,  smooth,  hyperiEmlc  patches,  which  clear  away 
later.  There  Is  no  deep-spreading  loss  of  substance,  but  at 
most  shallow  depressions.  As  severe  ulcers  of  the  skin  are 
avoided  there  are  for  the  most  part  no  resultant  serious  general 
symptoms  (Engel-)). 

The  results  of  this  treatment  in  small-pox  Induced  Chatin- 
ierCy)  Backmaiin  *)  and  Th.  Schiller-')  to  try  it  recently  in 
measles.  Here,  too,  the  treatment  is  said  to  have  been  most  suc- 
cessful. The  hyperpyrexia  was  lessened  and  the  laryngeal  and 
bronchial  symptoms  Improved.  In  scarlet  fever  and  erysipelas, 
too,  according  to  E.  Schouli,'')  Festner^')  Schiller  and  Kruken- 
herg,^)  good  results  followed  Its  adoption,  the  course  of  the 
illness  being  modified  in  duration  and  severity. 

The  question  here  arises:  Are  we  justified  in  calling  this 
therapy  chromo-therapy  ?  The  name  might  suggest  the 
thought  that  light  of  a  certain  colour  has  a  healing  action  on 
these  morbid  processes. 

Such  an  assumption  cannot,  we  think,  be  based  on  the  data 
quoted  in  the  preceding  paragraphs.  We  have  seen  that  it  is 
not  only  the  exclusion  of  the  chemical  light  rays,  that  is,  of  one 
component  ofwhite  light,  which  has  good  results {F cicl , Fi nseii)  ; 
we  know  that  darkness,  that  is  the  complete  exclusion  of  light, 
may  act  in  precisely  the  same  way.  This  Is  proved  both  by  the 
observations  of  Barlow  and  JVaiers,  and  by  the  fact  that  per- 
sons who  have  had  small-pox  are  free  from  scars  In  the  parts 
which  have  been  covered  up,  /.  c.,  kept  in  darkness  during  the 


')  Quoted  by  Finscn. 

*)  Therapie  d.  Gcgenwart,  igor,  No.  3.  • 

')  La  Prcsse  medic,  1898,  No.  75. 

*)  Quoted  by  Bic,  Mitthcilungcn  aus  Fiiiscn's  Licbtinst,  IT,  p.   150. 

')  Ibid. 

•)  Refer.  Zeitschr.  f.  diat.  u.  pbys.  Th..  Vol.  Ill,  p.  612. 

')  Quoted  by  Bie,  Behandlung  von  Maseru  u.   Scbarlacli  mit  Ausschl.  d. 
sog.  chem.  Lichtstrahlen  Mittb.  a.  Finscn's  Liclitinsl..  11.  \).   i4(). 

')  Miinchen.  med.  Wochenscbr.,  1901,  April  ist. 


458  RADIO-THERAPY 

illness.  From  this  point  of  view  we  might  regard  Finsen's  red- 
light  treatment  as  a  modification  of  Barlow's  and  Waters'  dark- 
ness-treatment, a  form  of  cure  both  easier  to  carry  out  and 
more  pleasant  for  the  patient.  It  would  not  be  easy  to  keep  a 
sick-room  permanently  and  absolutely  dark  ^) . 

But  it  does  not  follow  that  the  red  rays  do  not  play  a  certain 
active  part  in  this  therapy.  We  have  as  yet  made  no  study  as 
to  the  action  of  these  rays  on  morbid  processes,  and  it  does  not 
seem  improbable,  when  we  remember  the  favourable  influence 
of  the  allied  heat  rays,  that  they  too  should  have  beneficial 
action.  This  theory  would  be  in  accord  with  Engel's  observa- 
tions; he  tells  us  that  the  treatment  of  small-pox  patients  in  a 
red  room  has  no  effect  on  the  eruption  in  the  mucous  membrane 
of  the  upper  air  passage,  i.  e.,  on  parts  which  are  usually  in 
darkness. 

Many  observations  point  to  the  active  part  played  by  the 
less  refrangible  rays  in  the  various  physical  phenomena.  We 
know  (Cf.  p.  446)  that  on  many  substances  they  have  a 
stronger  chemical  effect  than  the  more  refrangible  rays.  We 
have  evidence,  too,  of  a  certain  antagonism  between  the  actions 
of  these  two  classes  of  rays,  of  the  neutralization,  to  some 
extent,  by  the  red  rays  of  certain  effects  of  blue  and  violet  rays. 
According  to  Eder,-)  Herschel,  as  long  as  1830,^)  found 
that  red  rays  have  an  opposite  effect  from  blue  ones  on  certain 
photographic  papers.  Fizeau  and  Foucault,^)  too,  have 
described  very  precisely  the  so-called  negative  effect  of  certain 
light  rays.  Claudet^)  in  1847  demonstrated  that  the  red  and 
yellow  rays  of  the  spectrum  check  the  action  of  the  others 
(especially  blue  rays  on  bromide,  iodide,  or  chloride  of  silver), 
or  reverse  it,  If  it  has  already  taken  place.  Later  he  found") 
that  red  and  yellow  light  always  have  a  negative  or  destructive 
effect  on  bromo-iodide  or  br.omo-chloride  plates,  but  act  on  clean 


^)  In  this  sense  we  should  have  to  look  on  the  exclusion  of  light,  which 
is  insured  by  dressings,  as  a  factor  in  the  healing  of  wounds. 

")  Ausfiihrl.  Handb.  d.  photogr.,  I,  i,  p.  262. 

')  Biblioth.  Univ.  de  Geneve.    New  Series.  Vol.  XXIII,  p.  185. 

')  Compt.  rend..  Vol.  XXIII,  p.  679. 

'')  Philosoph.   transact.,    1847.    Daguerreian  Journ.,    1851,   Vol.    I,   p.    161. 

')  Philosoph.  Magaz.,  Vol.  XXXII,  p.  199. 


PllOTOrHERAPY  459 

iodide  of  silv^er  plates  sometimes  negatively  and  sometimes  the 
same  way  as  blue.  As  regards  the  relative  action  of  the  single 
rays,  according  to  Claudct,  in  order  to  reverse  the  action  of 
white  light  that  has  acted  for  the  time-unit  i,  red  light  requires 
50  units,  orange  15,  yellow  18.  Jf^aterhouse's'^)  investiga- 
tions showed  that  each  part  of  the  spectrum  (from  red  up  to 
violet)  may  neutralize  a  previous  action  of  light  on  silver 
bromide. 

The  importance  for  our  present  subject  for  this  kind  of 
action  must  not,  It  is  evident  from  these  instances,  be 
disregarded. 

Yet  further  experiments  with  photographic  preparations 
show  that  the  opposed  action  of  the  red  and  the  violet  light  Is 
by  no  means  proved,  and  that  In  fact  the  two  ends  of  the  spec- 
trum rather  work  in  concert. 

The  antagonism  in  the  effect  of  red  and  violet  rays  on  phos- 
phorescence is  interesting  and  highly  important  as  bearing  on 
the  present  question;  we  shall  recur  to  it  later  on. 

Mental  and  nervous  affections  would  seem  to  offer  another 
field  for  chromo-therapy. 

Akopenko,-)  w^orking  in  Bechterew's  laboratory,,  proved 
that  the  colour  of  the  light  unquestionably  affects  the  duration 
of  psychical  processes,  and  that  the  various  rays  have,  in  this 
respect,  various  effects,  according  to  their  position  In  the  spec- 
trum. The  nearer  we  approach  the  heat  rays  of  the  spectrum 
the  more  invigorating  and  quickening  become  the  effects  of  the 
colours.  The  mood  of  the  person  under  observation  is  affected: 
in  red  light  he  feels  brisk  and  cheerful,  inclined  to  move  and  to 
act.  Physical  effects  are  produced;  e.  g.,  at  the  close  of  the  sit- 
ting headache  sometimes  has  disappeared.  Yellow  light  has 
no  special  effect  on  the  quickness  of  physical  reaction  and  on 
the  temperament,  being  in  this  respect  like  daylight.  Rays  of 
shorter  wave-length  have  a  depressing  effect,  so  that,  e.  g.,  pro- 
longed stay  In  a  room  with  green  light,  though  at  first  pleasant, 
becomes  later  oppressive.      Under  the  influence  of  green  light 


')    Proceedings  of  the  Royal  Soc,   London,  XXIV,  p.   186. 
")  Quoted  from  Dworctcliy's  Refer.  Zeitschr.  f.  diiit.  u.  phys..  Th.,  Vol. 
V,  p.  165. 


46o  RADIO-THERAPY 

psychical  processes  are  retarded :  mental  quietude  results,  move- 
ment is  checked,  excitement  allayed.  This  depressing  effect  is 
still  greater  in  violet  light.  The  mental  attitude  becomes  mel- 
ancholy, dreamy;  after  some  time  headache  is  felt.  The 
psychical  processes  are  checked  and  become  very  slow,  whilst 
the  feeling  of  general  depression  becomes  almost  unbearable. 

The   above   coincides   with   Goethe's    observations: 
He  noted  that  red  and  yellow  light  was  bracing,  green 
and  blue   depressing.        Baron  ReichenbacJis  observa- 
tions were  to  the  same  effect. 
V.  Jaksch,^)  too,  emphasizes  the  soothing,  soporific  effect  of 
blue  light,  and  he  consequently  used  blue  lamp  chimneys  in  his 
sick  wards.    On  the  other  hand,  G.  Oleinikow-)   reports  that 
patients  seriously  ill,  when  kept  in  the  red  room,  suffered  from 
delirium  with  frightful  hallucinations,  but  these  passed  away  at 
once  on  their  being  carried  into  a  light  room. 

According  to  Bine,  Fere  and  Gilles  de  la  Tourette,^)  red 
light  strengthens  the  nerves.  It  was  noticed  in  the  photo- 
graphic plate  factory  of  Linniere  Bros.,  in  Lyons,  that  the  work- 
men in  the  red  rooms  were  singularly  lively  over  their  work, 
singing,  arguing  loudly,  gesticulating  vehemently.  When  the 
red  panes  were  replaced  by  green  they  became  much  quieter. 

The  author's  own  experience  does  not  quite  accord 

with  this.   He  heard,  on  enquiry  from  many  professional' 

photographers,    that    they    felt    most    depressed    after 

spending  any  length  of  time  in  the  dark  room. 

Ponza  *)  was  the  first  to  try  the  practical  effect  of  chromo- 

therapy  on  mental  disease.      He  noticed  that  persons  affected 

with  melancholia,  after  a  short  time  (3  to  24  hours)  in  the  red 

room,  became  cheerful  and  chatty  and  were  ready  to  take  food, 

v/hilst  the  blue  room  had  a  quieting  effect  on  maniacs  who  had 

already    required   the   straight-waistcoat.       The   editor   of  the 

Inventuo  Medica,  in  Guatemala,  is  said  to  have  observed  the 

same  20  years  before. 


^)  20.  Congr.  f.  innere  Medicin,  1902. 

")  Jeshenedelnik,   1900,  No.  38. 

")  L'annee  electr.,   1901,  p.  368. 

')  Annales  Medico-Psychologiques,   1876,  Vol.  XV,  Scr.  V. 


PHOTOTHERAPY 


461 


Up  to  now  blue-diffused  sunlight  has  been  little  used  in 
photo-therapy.  General  Plcasiuitoi  claims  to  ha\e  effected 
complete  cure  in  a  case  of  contusion  by  thrice-repeated  irradia- 
tion for  half  an  hour').  In  many  districts  of  the  Bohmer- 
wald  erysipelas  is  treated  by  packing  the  affected  part  with  blue 
cloths  and  carefully  keepini^  off  white  light.  Probably  the  blue 
colour  of  the  material  that  shuts  oft  the  light,  though  insisted  on, 
is  of  no  practical  value. 


Couccutrutcd  SiDiliglit. 

§  62.  Concentrated  sunlight  is  obtaineci  by  using  convex 
lenses  or  concave  mirrors.  Long  ago  isolated  cases  of  lupus  were 
treated  (by  Thuxtr,  Mclil  and 
a  layman  mentioned  by  Otter- 
beinj-)  )  by  means  of  sunlight 
concentrated  by  a  burning  glass 
on  the  aftected  part,  and  good 
results  were  obtained.  Suitable 
as  this  simple  apparatus  is  for 
the  intensifying  of  the  light 
action  proper,  it  has  one  failing 
which  pre\ents  its  general  prac- 
tical use  in  therapeutics;  viz., 
with  a  simple  convex  lens  not 
only  the  light,  but  also  the  heat 
rays,  are  gathered  into  focus,  in 
which  such  a  high  temperature 
is  generated  that  it  is  simply 
impossible  to  expose  living  mat- 
ter to  it  for  any  length  ot  time. 
In  order  to  eliminate  the  heat 
rays  F'uisoi  a\ailcd  himself  of  a 
method  of  filtering  by  means  of 
cokl    water;    which     had    been 

often     used     by     physicists,     antl     ,.-„.    „3._(Concrntr,it,nK       apiuratus 

also  in  physiological  experiments  im-  ^uii!i.ulii. —/•/;/.?<•;/.) 


')    Chicago  Times,  (|uoU-<l  liy   h'diini. 


')    Oiinlfd  liy  h'iii.u-u. 


462  RADIO-THERAPY 

{e.  g.,  by  fVidmark) .  His  apparatus  consists  of  a  plano-convex 
hollow  lens,  20  to  24  cm.  in  diameter,  filled  with  cold  water; 
this  lens  is  mounted  in  a  forked  stand  in  such  a  manner  that 
it  can  be  moved  in  any  direction  on  a  vertical  and  horizontal 
axis,    and    can    at    the    same    time    be    raised    and    lowered 

(Fig.    93)- 

With  this  apparatus  all  the  components  of  white  sunlight 
are  not"  directed  on  the  diseased  spot,  for  the  ultra-violet  rays 
are  much  absorbed  on  their  passage  through  the  glass.  The 
liquid  used  in  the  cold  filter  has  also  a  great  effect  on  the  quality 
of  the  light  passing  through.  Distilled  water  indeed  absorbs 
very  little,  but  the  ultra-violet  rays  are  sensibly  weakened  by  the 
additions  of  methyl-blue  or  ammoniacal  sulphate  of  copper 
which  Finsen,  who  uses  only  the  chemical  rays,  put  In  at  first  to 
filter  away  the  less  refrangible  rays. 

If  a  blue  filtering  fluid  of  this  kind  (a  solution  of 
double  sulphate  of  copper  and  ammonia),  in  a  vessel 
(quartz)  allowing  the  passage  of  ultra-violet,  be  intro- 
duced in  front  of  the  opening  of  the  lattice  spectroscope 
In  the  path  of  the  light  rays  from  the  spark  produced 
between  electrodes  of  Eder  alloy,  and  the  spectrum  be 
then  photographed,  the  plate  will  show,  when  developed, 
that — with  a  layer  of  5  per  cent,  solution  of  ammonia- 
copper  sulphate,  an  opening  of  o.i  mm.  and  an  expos- 
ure of  3  minutes — the  spectrum  has  been  broken  off  at 
the  air-line  A  =■  3955-    Thus  a  light  filter  of  that  kind, 
under  these  conditions,  allows  blue  and  violet  light  to 
pass,  but  practically  no  ultra-violet. 
The  use  of  blue  light  filters  has  now  been  given  up  on 
account  of  their  weakening  of  the  light. 

Quartz,  which,  according  to  Stokes,  lets  more  ultra-violet 
rays  through  than  any  other  material,  should  really  be  used  for 
this  optical  apparatus,  in  ordfr  to  make  it  as  pervious  as  possi- 
ble. (According  to  Hankel,  Storer,  Eder  and  Valenta,  ordi- 
nary glass  absorbs  very  much  ultra-violet,  hard  flint  glass  and 
all  plumbiferous  glass  more  than  crown  glass  and  baryta-flint.) 
But  according  to  Finsen,  glass  does  let  through  the  relatively 
weak  ultra-violet  rays  of  sunlight,  and  In  any  case  pieces  of 


PHO  TO  THERAPY  463 

quartz  of  the  required  size  would  be  hard  to  obtain,  and  appara- 
tus fitted  up  with  quartz  lenses  would  be  very  expensive. 

For  the  rest,  the  favourable  results  obtained  by  Finsen  with 
his  old  apparatus  (glass  lens  and  blue  light-filters)  are  proof 
that  it  is  not  so  very  important  that  the  irradiation  should  be 
with  pure  ultra-violet  rays.  Ultra-violet  rays  of  low  intensity 
are  absorbed  by  the  surface  layers  of  the  skin,  whilst  if  raised 
to  higher  intensity  {e.  g.,  by  the  Baug  lamp)  they  soon  produce 
violent  inflammation.  It  would  hence  appear  wiser  in  treating 
skin  diseases  (lupus)  not  to  lay  such  great  stress  on  the  use  of 
the  rays  of  shortest  wave-length,  but  rather  to  confine  oneself  to 
the  rays  of  somewhat  greater  wave-length.  The  latter  have 
more  penetrating  power  (vide  the  blackening  of  photographic 
plates  by  sunlight  that  has  passed  through  thick  parts  of  the 
body)  and  at  the  same  time  they  possess  the  desired  chemical 
and  therapeutic  efl'icacy(cf.  Finsen  s  results),  though  not  to  such 
an  extreme  extent  as  to  injure  healthy  tissues  before  affecting 
the  morbid  growths. 

Concave  mirrors  serve  to  concentrate  greater  quantities  of 
light  than  can  be  done  with  lenses.  Strcbel  uses  metal  reflect- 
ors, I  metre  in  diameter,  with  water-cooling  arrangements  in 
front  of  them. 

The  method  of  treatment  with  concentrated  light  and  its 
results  in  lupus  vulgaris  will  be  fully  dealt  with  later,  in  con- 
nection with  the  arc-light  treatment,  which  is  based  on  the  same 
principles. 

E.  Nesnamozi'^)  made  some  interesting  experi- 
ments with  the  cure  of  suppurating  processes  in  the 
cornea  by  sunlight.  He  used  a  collecting  lens  similar 
to  Finsen's.  Five  severe  ulcers  in  the  cornea  were 
treated  for  2  to  5  minutes  daily  with  blue-violet  sun- 
light, with  excellent  results. 

6.    Treatment  zvitli  Artific'uil  Sources  of  Light. 
§  63.   Sunlight  is  so  little  to  be  relied  on  that  one  is  driven  in 


')   Westnik   Ophthalmologii.    1901.    J.in.    and    Vvh.  ;   cf.    Dzvorctzky,    Zcit- 
schr.  f.  diat.  u.  phys.  Th.,  Vol.  V,  Part  III. 


464  RADIO-THERAPY 

photo-therapy  to  fall  back  mainly  on  artificial  sources  of  light. 
Naturally  the  attempt  is  made  to  bring  their  intensity  as  nearly 
as  possible  up  to  that  of  sunlight,  and  to  heighten  as  much  as 
may  be  their  illuminating  power.  Here  we  must  distinguish 
clearly  between  the  optical  brightness  of  a  light,  which  is  a  mat- 
ter of  its  physiological  effect  on  the  eye,  and  its  chemical  or  pho- 
tographic illuminating  power.  Many  a  light  which  seems  very 
bright  to  our  eye  has  little  or  no  effect  on  photographic  plates 
and  other  light-sensitive  preparations,  whilst  many  pale-blue 
flames  have  considerable  photo-chemical  effect.  The  illuminat- 
ing power  of  the  sun  is  524  times  that  of  magnesium,  but  it  is 
only  5  times  more  powerful  chemically.  Burning  magnesium 
has  as  powerful  a  chemical  effect  as  the  sun  at  10°  altitude  with 
no  clouds  about,  /.  e.,  if  both  light  sources  have  the  same  appar- 
ent superficies.  With  the  sun  at  22.4°,  its  chemical  effect  is 
2)6  times  that  of  magnesium  [Binisen  and  Roscoe) . 

It  is  desirable  for  the  various  purposes  of  photo-therapy  to 
have  light-sources  of  considerable  optical  brightness  and  chemi- 
cal power.  Most  kinds  of  artificial  light  have  very  little 
brightness  as  compared  with  sunlight.  There  are,  however, 
light  sources  which  are  extraordinarily  powerful,  chemically  or 
photographically.  Thus  the  light  of  burning  magnesium  is 
very  rich  in  violet  and  ultra-violet  rays  {Schrotter,  Bnnscn, 
Roscoe)  ;  it  is  so  powerfully  actinic  that  in  the  fraction  of  a 
second  4  to  5  grammes  of  magnesium  powder  will  develop 
chemical  illuminating  power  equal  to  that  of  a  million  candles. 
In  the  same  way  there  is  very  much  violet  and  ultra-violet  in 
both  the  electric  arc-light  and  the  light  of  sulphide  of  carbon 
burning  in  nitrous  oxide  gas  (//.  IF.  Vogel). 

These  light  sources  are,  as  regards  their  chemical  rays, 
superior  to  the  Driimond  lime  light,  which  is  very  rich  in  yel- 
low and  red  rays  (Becquerel) . 

The  electric  mercury  light  of  the  fFay  lamp  ^)  is  very  rich 
in  blue,  violet  and  ultra-violet  rays,  being  more  actinic  than  the 
electric  light  from  carbon  points  {Monckhoven,  Bullet,  soc. 
franc.,  1871,  p.  210),  but  it  gives  hardly  any  red  rays,  differing 


')   In  this  a  strong  electric  current  is  sent  through  a  thin  thread  of  free- 
falling  mercury. 


PHOTOTHERAPY  465 

from  the  light  of  the  voltaic  arc  between  carbon  points;  further, 
it  is  dangerous  on  account  of  the  mercurial  vapours  given  off. 

This  light  {fTay's  light)  affects  photographic  bromide  and 
iodide  of  silver  plates  almost  as  powerfully  as  sunlight,  and 
decomposes  iodine  salts  even  more  forcibly.  The  electric 
incandescent  light  from  a  carbon  filament  is  yellower  than  the 
voltaic  arc,  and  much  less  actinic.  The  light  of  burning  zinc 
is  rich  in  blue  rays,  but,  as  compared  with  magnesium,  poor  in 
violet. 

According  to  Edcr,  of  all  known  artificial  light  sources, 
magnesium  powder  gives  the  most  powerful  chemical  effect  rela- 
tively with  the  shortest  combustion  ^). 

Thanks  to  its  richness  in  the  more  refrangible  rays  (blue, 
violet,  ultra-violet),  magnesium  light  is  very  actinic.  Unfor- 
tunately, this  light  burns  away  wnth  extraordinary  rapidity,  so 
that  it  is  not  possible  to  keep  it  continuously  powerful,  and,  fur- 
ther, it  gives  off  too  much  smoke  to  allow  it  to  be  used  for  a  pro- 
longed period,  as  is  for  the  most  part  necessary  in  photo- 
therapy. For  this  reason  the  electric  arc  and  spark  lights, 
which  come  next  to  magnesium  light  in  chemical  strength,  are 
mainly  employed  for  photo-therapeutic  purposes.  Of  the  other 
light  sources,  from  which  light  is  emitted  by  increasing  heat- 
energy  of  the  bodies,  only  the  acetylene  light  in  concentrated 
form  has  been  so  far  used  in  photo-therapy.  G.  Colleville-) 
reports  that  he  has  had  good  results  with  this  in  cases  of  slug- 
gish ulcers.  The  electric  incandescent  light  is  used  successfully 
for  all  such  methods  of  photo-therapeutic  treatment  as  require 
mainly  rays  of  greater  wave-length. 

Treatment  ziith  Electric  Incandescent  Light. 

§  64.  The  electric  incandescent  light  has  a  very  similar  spec- 
trum to  that  of  petroleum  and  gas  incandescent  light;  it  is  poor 
in  violet  and  blue  rays  and  rich  in  yellow,  red  and  green.  Its 
chemical  (photographic)  efficacy  is  therefore  slight,  but  this  may, 


')   Edcr's  Ausfiihrl.  TIandb.  d.  Pliotngr.,  I.  I,  pp.  455.  45<J,  457- 
*)    Gaz.  hebd.  d.  medcc.  Oct.  5.  1899. 


466 


RADIO-THERAPY 


as  well  as  Its  brightness,  be  materially  Increased  by  strengthen- 
ing the  current,  as  Is  proved  by  the  following  table  {Abney  ^)  )  : 


Number  of  Grove 

Illuminating  Power 

Photographic 

Elements 

in  Normal  Candles 

Effect 

12 

0.132 

immensurable 

14 

0.  26 

0-35 

16 

I. 17 

1. 61 

18 

2.44 

5-83 

20 

3-84 

12.84 

22 

6.85 

36.45 

24 

10.38 

86.60 

Increasing  the  strength  of  the  electric  current  not  only 
affects  the  optical  brightness  of  the  electric  Incandescent  light, 
but  also  the  amount  of  Its  blue  and  violet  rays.  Strong  cur- 
rents, however,  destroy  the  Incandescent  lamp  very  quickly. 

In  general  380  incandescent  lamps  of  normal  power  with- 
out reflectors  have  the  same  chemical  effect  as  natural  light  at  a 
distance  of  one  metre  from  the  object.  When  It  Is  a  question 
of  producing  Intense  chemical  light  rays  (as  In  the  treatment 
of  lupus)  the  electric  Incandescent  light  is  of  little  value,  but  It 
Is  exceedingly  useful  where  longer-waved  rays  (heat  rays,  red 
light)  are  to  be  applied. 

The  treatment  with  electric  Incandescent  light  Is  either  gen- 
eral, In  the  shape  of  electric  Incandescent  baths,-)  or  local. 

The  first  apparatus  for  these  baths  was  described  by 
/.  H.  Kellog  In  1894^)  and  shown  at  the  Chicago  Exhibition. 
The  first  Incandescent  baths  were  Introduced  Into  Germany  by 
the  Chemist  Gehhard;  many  improvements  have  since  then  been 
made  In  them.  They  are  arranged  sometimes  for  a  sitting, 
sometimes  for  a  recumbent  position  of  the  patient,  but  are 
always  constructed  on  the  same  principle.  Sometimes  they 
have  arrangements  attached  by  means  of  which  the  arc-light  and 
incandescent  light  can  be  brought  to  bear  on  the  patient  at  once. 


')   From  Eden's  Ausfiihrl.  Handh.  d.  Photogr.,  I,  i,  p.  463. 

")   For  arc-light  baths,  cf.  p.  383. 

')   American  Electrotherapeutic  Association,  Sept.,  1894. 


PHOTOrilERAPY  467 

Modern  incandescent  baths  are  made  for  connection  with 
the  street  electric  wires.  They  consist  of  octagonal  boxes,  sup- 
plied with  panes  of  mirrors,  opalescent  glass  plates,  etc.,  and 
fitted  with  a  door,  fastening  on  the  inside  and  outside,  for  the 
entrance  of  the  patient,  and  with  a  movable  lid  above  with  a 
hole  for  the  patient's  neck.  Along  the  inner  walls  40  to  60  incan- 
descent lamps,  each  of  16  normal  candle  power,  are  arranged; 
these  lamps  can  be  put  in  or  withdrawn  from  without,  and  if 
necessary  from  within,  by  means  of  several  switches  (in  Rieders 
apparatus  arranged  on  one  switch-board)  in  series,  along  ver- 
tical, horizontal  or  spiral  lines.  The  lamps  are  protected  by 
lattice  work.  A  thermometer  for  measuring  the  inside  temper- 
ature is  fixed  on  the  wall.  Recently,  too,  a  window  has  been 
put  in  the  wall  of  the  chamber,  through  which  the  pulse  and  the 
course  of  the  perspiration  may  be  observed.  By  means  of  other 
openings  with  roll-shutters  light  may  be  admitted  from  an  arc- 
light  reflector.  It  is  as  w^ell  to  have  an  electric  bell  fixed  inside 
the  chamber. 

The  patient  is  seated  naked  on  a  stool  in  the  light  box;  light 
from  without  is  completely  shut  off  by  a  towel  round  the  neck 
opening.      A  cold  bandage,  or  ice-cap,  is  applied  to  the  head. 

The  temperature  of  a  light-bath  should  not  begin  with 
more  than  110°  to  122'^  F. ;  only  after  the  way  the  patient 
reacts  has  been  carefully  noted  may  the  temperature  be 
raised  to  156''  to  167''.  The  bath  should  last  in  all  25  to 
30  minutes. 

It  depends  on  the  special  case  whether  the  box  should  be 
heated  beforehand  or  not.  In  the  case  of  an  otherwise  strong, 
healthy  person,  where  powerful  light-action  {e.  ^.,  in  producing 
perspiration)  is  desired,  he  may  be  put  into  a  previously  heated 
chamber.  The  sudden  stimulus  of  the  high  temperature  in 
such  a  case  has  great  effect  (similar  to  the  stimulus  of  the 
switching  on  and  off  of  the  electric  currents).  But  with  weakly, 
ailing  persons  this  ])lan  must  not  be  adopted;  the  air  in  the 
chamber  must  be  heated  gradually  after  the  patient  is  in  the 
bath.  The  temperature  can  be  raised  by  adtiing  to  the  number 
of  lamps  and  increasing  the  strength  of  the  current.  During 
the  bath  the  \mV:x  r)f  the  patient  must  be  constantly  observed 


468  RJDIO-THERAPY 

and  care  must  be  taken  for  the  admission  of  fresh  air.  After 
the  hght-bath  follows  a  bath,  douche,  or  wet  pack. 

These  baths  should  not  be  taken  daily,  but  twice,  or  at  most, 
three  times  a  week. 

The  action  of  the  incandescent  bath  is  mainly  that  of  radi- 
ating heat.  We  are  able  by  these  means  to  apply  heat  to  the 
deeper  tissues;  we  have  seen  (p.  436)  that  the  heat  rays  easily 
penetrate  even  bones  {Moelltr),  and  this  it  is  which  constitutes 
the  value  of  this  treatment. 

The  conducted  heat  from  water,  vapour,  Russian,  Turkish, 
Irish  baths,  etc.,  confines  its  action  to  the  surface  of  the  body. 

Yet  the  light  rays  may  perhaps,  side  by  side  with  this  action 
of  radiant  heat,  have  certain  other  effects.  The  light  of  these 
incandescent  lamps  is  indeed  poor  in  so-called  chemical  rays,  and 
consists  mainly  of  red,  yellow  and  green  rays.  But,  as  has 
repeatedly  been  mentioned  above,  it  is  not  impossible  that  red 
and  yellow  rays,  too,  may  have  certain  biological  and  therapeu- 
tic effects. 

The  most  striking  effect  of  this  treatment  is  its  action  on 
the  secretion  of  sweat.  Whether  this  is  produced  by  stimula- 
tion of  the  peripheral  nerve-endings  or  by  the  raising  of  the 
patient's  temperature  by  the  radiant  heat  (Strebel)  we  cannot 
decide.  In  any  case  the  accumulation  of  heat  in  the  body  is 
obviated  through  the  profuse  perspiration. 

Kellog  ^)  observed  that  the  amount  of  sweat  excreted  In  the 
electric  Incandescent  bath  was  twice  as  much  for  the  same  time 
as  in  the  Turkish  bath,  whilst  the  average  temperature  In  the 
electric  light-bath  was  81°  F.,  and  in  the  Turkish  bath  140°  to 
148°  F.  Generally,  if  all  (50)  the  lamps  of  the  apparatus 
are  lighted,  perspiration  begins  after  6  to  10  minutes  at  about 
95°  F.  If  the  temperature  in  the  chamber  Is  raised  to 
I40°-I58°,  sweat  to  the  amount  of  a  litre  and  more  may  be 
excreted  In  a  short  time  (a  quarter  to  half  an  hour). 

Below  and  Aufrecht  note  the  very  Interesting  fact  that  In 
the  perspiration  of  persons  who  years  before  had  been  treated 
by  mercurial  inunction  traces  of  mercury  were  found.     Katten- 


^)  Fortschr.  d.  Hydrotherapie,  Festschr.,  Wien,  Leipzig,  1897. 


PHOTOTHERAPY  ^69 

bracker  found  0.26  per  cent,  of  sulphur  in  the  sweat  of  a 
glass-blower. 

Further  effects  of  incandescent  light-bath  on  the  circulation, 
respiration,  metabolism  and  weight  have  been  observed. 

It  has  been  asserted  that  the  action  of  the  heart  is  unchanged 
or  little  affected  in  the  incandescent  light  chamber.  Facts  do 
not  bear  this  out. 

M.  Roth  ^) observed  that  a  pulse  which  had  before  the  light- 
bath  been  steady  at  72  beats,  became  rapidly  quicker  after 
10  minutes  in  the  chamber,  giving  84  beats;  after  15  minutes, 
104;  after  20  minutes,  132.  At  first  it  remained  fairly  steady, 
but  later  it  grew^  thin,  galloping  and  irregular. 

On  the  whole  we  may  take  it  that  with  the  temperature  in 
the  light-chamber  at  about  122°  F.  the  pulse  is  quicker  each 
minute  by  about  15  to  20  beats. 

Strasser-)  and  Strebel^)  report  to  the  same  effect.  These 
changes  in  the  pulse,  however,  are  often  no  longer  so  marked  in 
succeeding  baths.  Increased  blood-pressure,  with  its  conse- 
quences (congestion,  bleeding  at  the  nose,  etc.),  has  been 
observed  as  one  of  the  immediate  results  of  this  treatment.  In 
most  cases,  however,  after  copious  perspiration,  when  the 
patient  has  stayed  20  to  25  minutes  in  the  bath,  the  blood- 
pressure  subsides  again. 

Winternitz*)  noticed  in  the  case  of  anemic  persons  an 
increase  of  hjemoglobin  and  erythroctes  after  each  light-bath. 

Respiration  is  powerfully  affected  by  the  bath.  •  The  breath- 
ing-often  becomes  twice  as  rapid  after  a  short  stay  (a  quarter  of 
an  hour)  in  the  chamber,  and  at  the  same  time  more  shallow 
and  superficial.  The  temperature  of  the  patient  is  raised  a  little 
by  about  2''  F. 

KcIIo^  found  in  the  case  of  three  persons  under  obser- 
vation, who  had  previously  exhaled  on  the  average  3.60  per 
cent,  of  carbonic  acid  in  ten  minutes,  that  the  amount  given  off 
was  by  the  incandescent  bath   increased  in   5   minutes  to  4.10 


')  Wr.  mcd.  Woclunsclir..   il^f/j,   No.   19. 

')  Encyclop.  Jahrl).,  1000. 

')  L.  c. 

*)  Bliittcr   f.   klin.   llydroth.   X.  Jahr.,    I'/X),   II.  6,   p.    144. 


470  RADIO-THERAPY 

per  cent.,  in  20  minutes  to  4.20  per  cent.,  and  in  30  minutes, 
5.13  per  cent. 

Light-baths  seem,  according  to  Roth's  investigations  on  the 
urine  and  perspiration,  to  have  no  specially  marked  influence  on 
organic  decay  in  the  body.  But  we  may  assume  that  the  higher 
body  temperature  observable  after  every  light-bath  furthers  the 
combustion  of  fat. 

The  body-weight  shows  after  each  bath  a  more  or  less 
marked  decrease,  according  to  the  amount  of  perspiration.  If 
the  patient  satisfies  the  violent  thirst  usually  but  not  always 
felt  by  drinking  freely,  the  loss  in  weight  is  very  soon  made  up; 
if,  however,  he  has  suitable  diet,  a  comparatively  short  time  suf- 
fices to  bring  down  his  weight  considerably. 

Occasionally  the  light-bath  brings  on  nervous  symptoms, 
such  as  palpitation  of  the  heart,  difficulty  in  breathing,  excitabil- 
ity or  languor. 

After  an  ordinary  light-bath  the  skin  shows  signs  of  simple 
though  marked  hyperaemia.  With  the  ordinary  type  of  bath, 
if  its  temperature  be  not  raised  so  as  to  scorch  the  skin,  the 
hyperaemia  disappears  very  quickly  (like  all  hyperaemia  brought 
about  by  radiant  heat),  without  leaving  behind  any  erythema 
or  pigmentation. 

All  we  know  as  to  the  action  of  electric  incandescent  light- 
baths  points  to  their  use  in  all  our  cases  where  copious  perspira- 
tion is  desired,  with  the  least  possible  strain  on  the  heart.  The 
light-bath 'is  distinguished  as  a  convenient  and  efficient  source 
of  heat  by  the  fact  that  its  temperature  can  be  exactly  regulated. 
It  may  safely  be  raised  far  higher  than  is  possible  in  vapour, 
Turkish,  Russian  and  Irish  baths,  because  most  patients,  under 
like  conditions,  perspire  sooner  and  at  a  lower  temperature  in 
the  light-bath  than  in  other  baths,  and  have  further  only  the 
body  and  not  the  head  exposed  to  the  heat.  Further  investiga- 
tions are  necessary  before  we  can  determine  how  far  we 
should  take  account  of  the  deep-seated  action  of  the  penetrating 
long-waved  light  rays  (red  and  yellow).  Ordinary  incan- 
descent light-baths,  then,  are  suitable  in  cases  of  faulty  assimila- 
tion (obesity,  diabetes,  gout),  rheumatic  affections  of  joints  and 
muscles,    nerve    complaints    (sciatica,    neuralgia,    neurasthenia, 


PHOTOTHERAPY  471 

hysteria),  anaemia  and  chlorosis,  chronic  poisoning  (metaUic 
poisoning,  syphihs),  chronic  exudation  and  effusions,  bronchial 
asthma  and  bronchitis,  dropsy,  ascitis  and  ccdema  after  nephri- 
tis, hypertrophic  and  fatty  heart,  eye  complaints  (keratitis  par- 
enchymatosa,  iridocyclitis,  choroiditis),  and  as  a  tonic  and  pro- 
phylactic against  disease. 

According  to  Strasser,^)  this  treatment  is  especially  suited 
to  the  hydremic  forms  of  corpulency,  particularly  the  ana^'mic, 
pasty-looking  type  found  in  young  people.  For  plethoric  cor- 
pulent patients  he  prefers  packs.  According  to  Strebel,  the  tem- 
perature of  the  light-bath  should  never  exceed  113°  F.  for  this 
class  of  patients. 

Incandescent  light-baths  are  usually  regarded  as  not  in  them- 
selves sufficient  treatment  for  diseases  due  to  faulty  assimilation. 
In  combination  with  suitable  diet  and  medicine  they  give,  how- 
ever, effective  help  in  cases  where,  owing  to  heart  complications, 
other  methods  of  inducing  perspiration  cannot  be  resorted  to. 
For  instance,  they  are  said  to  be  very  efficacious  in  gouty  com- 
plaints in  the  joints,  arterio-sclerosis,  etc.  They  are,  however, 
not  always  advisable  in  all  such  cases;  as  Strchcl  remarks  with 
truth,  in  gouty  complaints  a  thorough  transfusion  of  the  tissues 
with  fluid  is  desirable,  and  this  wholesale  process  is  checked  by 
the  great  loss  of  water  through  perspiration.  Strebel,")  there- 
fore, does  not  use  baths  producing  perspiration  in  such  cases, 
but  much  prefers  protracted  sun-baths  or  arc-light  baths,  in 
which  light  rays  and  not  only  heat  rays  come  into  play. 

The  same  holds  good  with  rheumatic  affections  of  the 
joints.  In  muscular  rheumatism,  however  (kimbago,  torticollis, 
etc.),  incandescent  light-baths  are  excellent. 

For  the  various  forms  of  anaemia,  incandescent  light-baths 
are  probably  relatively  less  effective  than  sun-baths.  The 
chemical  rays  in  the  latter  cause  lasting  hyperemia  and  pigmen- 
tation, and  thereby  a  removal  of  blood  corjuiscles  from  their 
ordinary  course,  thus  stimulating  the  system  to  replace  the  blood 
substance  and  simultaneously  to  carry  on  more  vigorously  the 
metabolic  processes    {J Jkvcutlial,  Sirchcl).        We  cannot  here 


')   Bliittcr  f.  klin.  Ilydrothcr.,  igoo,  Nos.  4.  5,  p.  94. 
^)    DciUscIk-  Mcdicin.  ZcitniiK,    looi,   Nos.  6-8. 


472  RADIO-THERAPY 

enter  into  the  question  of  whether  the  action  of  light  here  is 
helped  by  the  stimulus  to  the  marrow  given  by  the  red  sun  rays 
penetrating  the  bone  {Strebel). 

Incandescent  light-baths,  producing  only  temporary  hyper- 
aemia  of  the  skin  and  thereby  only  temporary  depletion  of  the 
internal  organs,  are  of  less  value  in  these  cases  where  the  latter 
effect  is  chiefly  aimed  at,  as  in  cases  of  congestion  of  the  internal 
organs  or  in  the  venasportae,  difficulty  of  breathing,  valvular 
heart  disease,  angina  pectoris,  etc.  In  all  these  cases  sun-baths 
or  arc-light  baths  are  more  suitable.  On  the  other  hand,  in 
dropsy,  caused  by  heart  or  kidney  disease,  incandescent  light- 
baths  are  a  great  advance  on  all  previous  treatment;  they  do 
not,  however,  much  affect  the  cause  of  the  trouble. 

Writers  are  much  divided  as  to  the  value  of  these  baths  in 
functional  diseases  of  the  nerves.  Whilst,  for  instance,  some 
cannot  speak  too  strongly  of  their  good  effects  in,  e.  g.,  neuras- 
thenia, their  soothing  influence  on  general  irritability,  sleepless- 
ness, singing  in  the  ears,  oppression  and  palpitation  of  the  heart 
(Co/owZ^o/)  )  others  {Strebel)  regard  a  patient  suffering  from 
neurasthenia  as  not  a  favourable  subject  for  this  treatment. 

It  seems  to  be  much  the  same  with  the  incandescent  light- 
bath  treatment  of  these  nervous  conditions  as  with  all  the  other 
methods  of  cure  tried  for  them.  One  patient  is  benefited, 
another  is  not;  much  depends  on  the  amount  of  confidence  in 
the  treatment  possessed  by  the  patient  himself. 

Sometimes  incandescent  light-baths  relieve  or  remove  neu- 
ralgia and  migraine  {Strebel,  Freimd) ,  but  by  no  means  always; 
many  cases  are  quite  refractory  to  the  method. 

It  has  been  held  by  many  ")  that  these  baths  have  a  specific 
influence  on  tuberculosis,  scrofula  and  other  infectious  diseases; 
here  bactericidal  action  of  light  being  assumed. 

As  we  have  more  than  once  stated,  such  an  assumption  is 
quite  mistaken,  for  it  is  well  known  that  incandescent  lamps  give 
out  very  few  of  the  chemically  active  rays,  which  are  more  bac- 
tericidal in  their  action  than  other  light  rays,  and  such  chemical 

)   Revue  de  Therapie  physique,  1901. 

^)  Ruhcmann,  Apery,  Kattenbrackcr,  Candler,  Minin,  Cleaves,  Below,  and 
others,  quoted  by  Boeder. 


PHOTOTHERAPY  473 

rays  as  are  completely  absorbed  on  their  passage  through  the 
glass  walls  of  the  lamp  and  the  tissues  of  the  body.  Obviously 
then,  assuming  the  light  source  to  be  sufficiently  rich  in  actinic 
rays  and  sufficiently  powerful,  we  can  only  consider  its  bacteri- 
cidal action  as  having  a  very  superficial  effect. 

It  may  be  urged  that  in  the  treatment  of  infectious  diseases 
it  is  not  the  actinic  rays  which  matter,  but  more  penetrating  long- 
waved  yellow,  red  and  heat  rays.  Experiments  with  bacteria 
cultures  show  that  these  rays  have  no  specially  pronounced  bac- 
tericidal properties.  These  experiments,  it  is  said  again,  need 
not  be  regarded  as  conclusive;  for  the  rays,  by  penetrating  the 
body,  set  up  hyperaemia  in  the  infected  organs,  which  acts  as  a 
curative. 

There  is  certainly  something  to  be  said  for  this  theory,  main- 
tained by  Strebel  amongst  others.  As  a  matter  of  fact,  various 
observers  have  reported  a  favourable  action  of  light  on  infected 
animals  {Kondraticw,  De  Renzi,  Kiitschiik,  Aufrecht^)) . 
Yet  Boeder's -)  experiments  show  no  specific,  and  specially 
no  specifically  bactericidal  effect  of  light  rays  on  infected 
animals. 

Drigalsky  ')  even  observ'ed  that  mice  inoculated  with 
splenic  fever  or  other  bacteria  died  more  quickly  in  the  light- 
bath  than  control-animals,  even  though  they  were  kept  only  a 
short  time  in  the  bath.  He  holds  that  the  very  copious  perspi- 
ration brought  on  by  the  heat  rays  weakens  the  resisting  pow- 
ers of  the  body,  and  calls  attention  to  the  danger  to  many 
feeble  patients,  e.  g.,  tuberculous  persons,  from  such  haphazard 
treatment. 

The  whole  question  calls  for  more  detailed  investigation, 
but  so  far  as  our  present  knowledge  goes,  we  may  say  that  any 
favourable  effect  of  light  treatment  on  infective  diseases  of  the 
internal  organs  must  be  explained  by  its  indirect  action  in  stim- 
ulating metabolism  and  the  action  of  the  heart,  and  in  increasing 
phagocytosis  and  perspiration,  etc. 

Incandescent  light-baths  are  unsuitable  in  cases  of  extreme 


^)   Quoted  by  Boeder. 

^)   Arb.  aus  dem  Kaiserl.  GcsundhcitsaniU'.  1900. 

')   Centralbl.   f.   BaklcrioIoBio.  Vol.  XXV.  II,  Nos.  22,  23. 


474  RADIO-THERAPY 

weakness  and  arteriosclerosis,  for  patients  with  organic  heart 
disease  and  marked  congestive  symptoms,  In  phthisis  with  night 
sweats,  in  haemorrhagic  cases  (haemoptysis,  haematemesis,  apo- 
plexy), and  In  all  cases  where  no  perspiration  results  from  the 
earlier  baths  {Rieder,  Strebel). 

Partial  light-baths  are  a  convenient  modification  of  the  gen- 
eral Incandescent  light-bath.  For  them  smaller  boxes  are  used, 
with  reflecting  surfaces  and  incandescent  lamps  fixed  to  the 
sides,  and  with  suitable  openings  for  the  Insertion  of  a  limb;  or 
else  one  or  more  lamps  are  used,  provided  with  a  reflector 
{Troiive,  Fovcau  de  Coiirmelles,  Laquer) . 

The  apparatus  (similar  in  principle  to  the  above)  which  the 
author  himself  uses  for  partial  light-baths')  (treatment  with 
radiant  heat)  consists  of  two  Incandescent  lamps  of  lOO  N.  can- 
dle-power, each  with  Its  own  cut-out  switch,  which  are  fixed  in  a 
parabolic  metal  reflector.  The  conducting  wires  are  carried  to  a 
rheostat,  the  lever  of  which  can  be  so  adjusted  as  to  regulate  the 
brightness  of  the  lamps.  On  Its  open  side  the  reflector  has  slots 
for  coloured  glass  filters  or  blinds.  This  apparatus  may  be 
either  fixed  to  a  stand,  or  it  may  be  attached  to  other  apparatus. 
In  treating  the  extremities  a  drum-shaped  box  Is  used,  an  open- 
ing being  cut  out  In  Its  casing  corresponding  to  the  exact  size  of 
the  reflector,  which  can  be  fitted  In.  The  drum  with  Its  reflec- 
tor Is  placed  on  two  supports  and  fixed  with  straps;  In  this  posi- 
tion It  can  be  turned  so  that  the  rays  fall  In  turn  on  all  parts  of 
the  limb  under  treatment.  Asbestos  netting  Is  stretched  Inside  the 
drum  at  some  distance  from  the  reflector  to  prevent  the  exposed 
limb  from  coming  too  near  the  lamps. 

Another  apparatus  for  treating  the  trunk  or  single  parts  of 
it  consists  of  a  trough-shaped  framework  covered  with  thick 
heat-retaining  material.  Curtains  of  the  same  material  with 
tapes  cover  the  two  ends.  The  trough  has  a  rectangular  open- 
ing at  the  top  into  which  the  reflector  fits.  Below  this  opening, 
but  attached  to  two  rollers  on  the  outside  of  the  trough,  is  a 
thick,  close  curtain  of  asbestos,  consisting  of  two  nets,  one  coarse 
and  the  other  fine-meshed,  put  one  above  the  other.      By  draw- 


^)   This  was  made  by  L.  Schnlnicislcr,  Vienna,  IX. 


PHOTOTHER/IPY  41S 

ing  the  one  or  the  other  part  of  the  curtain  by  means  of  the 
rollers  the  Irradiation  may  be  varied  in  strength. 

Both  these  apparatus  are  fitted  with  thermometers.  The 
action  of  such  partial  light-baths  is  precisely  similar  to  that  of 
the  general  incandescent  light-baths,  but  in  some  respects  the 
former  are  much  superior.  They  are  useful  for  the  treatment 
of  bed-ridden  patients  who  cannot  be  moved  to  the  larger  bath. 
Then  they  are  more  suitable  for  many  cases,  because  a  far 
higher  temperature  can  safely  be  used  with  them.  A  tempera- 
ture of  over  122°  F.  is  unpleasant  in  the  general  bath,  but  with 
these  apparatus,  especially  at  a  second  and  a  third  bath,  temper- 
atures of  2  12"^  F.  and  more  are  borne  without  inconvenience. 
When  parts  only  of  the  body  are  exposed  to  the  rays,  perspira- 
tion does  not  result  except  at  a  high  temperature  (from  194°  F. 
to  221°  F.),  but  it  is  then  usually  very  profuse. 

It  is  interesting  to  note  that  irradiation  of  the  extremities 
raises  the  temperature  of  the  whole  body.  The  writer  has 
made  repeated  observations  on  this  point  with  patients  under 
treatment  for  the  joints  of  the  hands  and  feet.  Half  or  three- 
quarters  of  an  hour  after  the  treatment  had  begun,  when  the 
temperature  inside  the  apparatus  was  about  176°  F.,  the 
patients  reported  themselves  as  getting  comfortably  warm  over 
the  whole  body.  At  the  same  time  the  face  became  a  little 
flushed,  and  the  temperature,  on  being  again  carefully  taken, 
showed  a  rise  of  from  3°  to  10°  F.  The  pulse  showed  on  the 
whole  no  change;  being  rarely  slightly  accelerated.  The 
respiration,  too,  was  unaltered. 

The  rising  temperature  may  be  explained  by:  i,  Heating 
of  the  body  by  heat  passing  from  the  apparatus  into  the  tissues; 
2,  higher  temperature  of  the  limb,  carried  over  the  whole  body 
by  the  heated  blood;  3,  sympathetic  rise  in  temperature,  through 
the  nervous  system.  Considering  the  comparatively  rapid  rise 
In  temperature  and  the  size  of  the  parts  under  treatment, 
together  with  their  slight  heat-conducting  power,  we  may  proba- 
bly disregard  the  first  explanation.  Which  of  the  other  two  Is 
the  more  effective  we  can  hardly  for  the  present  determine;  pos- 
sibly each  has  an  equal  share  In  the  result. 

The  method  of  this  treatment  Is  as  follows:    If  a  powerful 


476  RADIO-THERAPY 

stimulus  is  to  be  administered  to  the  affected  limb,  it  is  put  into 
an  apparatus  heated  beforehand  to  about  122°  F. ;  if,  however, 
a  longer  irradiation  be  desired,  the  current  is  only  turned  on 
after  the  apparatus  is  applied  to  the  patient.  Various  methods 
may  be  adopted  to  make  prolonged  application  of  the  treatment 
bearable.  The  curcent  may  be  weakened  by  means  of  the 
rheostat  when  the  irradiation  becomes  unpleasant;  or  one  or  both 
lamps  may  be  switched  off  for  a  longer  or  shorter  time;  or 
radiant  heat  is  dispensed  with  altogether  for  a  time  and  only  the 
thermometric  heat  of  the  box  utilised  (this  is  done  by  simply 
placing  a  dry  linen  compress  on  that  part  where  the  heat  is  felt 
unpleasantly,  to  keep  off  the  direct  rays) .  By  these  means  the 
treatment  may  be  variously  modified.  As  soon  as  the  desired 
result,  e.  g.,  perspiration,  is  attained,  treatment  Is  suspended, 
the  part  is  thoroughly  rubbed  down,  and  either  active,  passive 
and  resistance  movements  or  massage  applied.  One  should  not 
leave  the  affected  limb  in  the  apparatus  after  the  heat  has  been 
turned  off  and  allow  it  to  cool  down  gradually.  The  author's 
experience  has  proved  this  procedure  to  be  most  harmful  to  the 
effect  of  the  treatment. 

For  the  treatment  of  superficial  skin  affections,  neuralgia, 
myalgia,  etc.,  we  use  the  simple  radiant  apparatus  with  or  with- 
out coloured  filters.  We  may  take  the  appearance  of  marked 
hyperaemia  of  the  skin  and  possibly  slight  perspiration  as  indica- 
tions for  suspending  the  treatment. 

The  symptoms  indicated  for  this  treatment  are  precisely  the 
same  as  those  for  the  general  incandescent  light-baths.  This 
method,  however,  may  be  said  to  be  more  universal  in  its  appli- 
cation, inasmuch  as  it  taxes  the  heart  to  a  much  less  degree. 
We  have  attained  excellent  results  with  this  method  when  sys- 
tematically carried  out,  both  in  relieving  painful  affections  of 
the  joints  and  muscles,  and  in  quickening  the  re-absorption  of 
serous  exudations  and  effusions  into  the  joints,  and  in  the  case 
of  dropsical  accumulations.  Rheumatic  pains  are  usually 
immediately  relieved.  Patients  who  could  hardly  stand  before 
the  treatment  are  able  to  walk  without  pain  after  it.  But  the 
effect  is  not  lasting;  the  pains  are  felt  again  after  one  to  three 
hours,  and  a  complete  cure  is  only  effected  when  the  treatment 


PHOTOTHERAPY    '  477 

has  been  prolonged  and  combined  with  suitable  medicinal  and 
mechano-therapeutic  measures. 

It  is  doubtful  whether  radiant  heat  can  do  much  for  neural- 
gia. Patients  indeed,  in  many  cases  of  trigennial  neuralgia, 
sciatica,  etc.,  professed  that  they  felt  relief,  especially  at  times 
from  treatment  with  rays  filtered  through  blue  glass.  But  in 
the  case  of  other  and  unhappily  of  most  patients,  their  suffering 
was  not  in  the  least  alleviated  by  the  treatment,  and  one  cannot 
help  thinking  that  in  the  successful  cases  something  was  due  to 
the  effect  of  suggestion. 

On  the  other  hand,  it  appears  that  irradiation  by  powerful 
incandescent  lamps  has  a  strikingly  good  effect  on  superficial 
inflammation  and  suppuration.  The  author  treated  at  times 
with  the  unfiltered  light  of  an  incandescent  light  apparatus,  at 
other  times  using  a  red  glass  filter  (spectroscopically  examined) , 
several  long-standing  cases  of  acne  vulgaris,  2  cases  of  ulcerat- 
ing Roentgen-dermatitis,  which  Prof.  EJirmann  had  passed  over 
to  him,^)  an  ulcerating  lupus,  and  a  scrofulous  abscess  which 
had  been  left  on  the  neck  after  ulceration  of  the  lymphatic 
glands,  and  a  syphilitic  ulcer.  The  disease  was  checked  or  les- 
sened in  all  these  cases  except  the  last-named,  which  was 
untouched,  and  the  scrofuloderma,  which  had  finally  to  be 
treated  surgically  in  spite  of  improvement  at  first,  because  of 
the  ulceration  of  the  neighbouring  gland.  In  the  other  cases, 
the  inflammatory  induration  round  the  acne  nodules  was  les- 
sened, fewer  pustules  were  formed,  and  the  suppuration  dimin- 
ished in  the  small  abscesses,  whilst  healthy  granulation  and 
surface-healing  were  visibly  furthered.  Ihe  irradiation  lasted 
each  time  at  least  half  an  hour,  with  the  diseased  part  as  close 
as  possible  to  the  light  source.  In  these  cases,  of  course,  no 
other  treatment  was  adopted,  the  sore  places  being  simply 
dressed  with  vaseline  after  each  sitting. 

It  has  been  already  observed  that  we  are  still  waiting  for  a 
complete  explanation  of  the  good  results  of  this  treatment, 
rhe  character  of  the  light  source  being  what  It  is,  we  cannot 
look  to  any  action  of  chemical  rays;  we  can  only  take  into 


')   Ges.  d.  Aerzte  in  Wicn,  Feb.  21  st,  1902 


478  'RADIO-THERAPY 

account  the  rays  of  greater  wave-length,  which  are  produced 
fairly  abundantly,  and  their  power  of  penetrating  the  deeper 
layers  of  the  slcin.  In  this  respect,  remembering  the  well- 
known  good  effect  of  high  temperatures  on  ulcerating  processes 
we  may  probably  assume  that  the  heat  rays  are  beneficial  in  this 
way;  it  may  also  be  that  the  irritation  of  the  deep-penetrating 
long-waved  rays  may  stimulate  healing  and  the  formation  of 
connective  and  scar-tissues,  just  as  chemical  irritants  do  when 
applied  to  sluggish  ulcers  ^)  for  the  stimulation  of  granulation- 
tissue  formation. 

The  effect  may  perhaps  be  made  more  intense  by  substitut- 
ing for  the  ordinary  incandescent  lamps  the  Auer  osmium 
lamps,  which  hav^e  a  stronger  illuminating  power. 

The  literature  on  this  subject,  especially  the  Rus- 
sian, describes  a  number  of  results  which,  even  allowing 
for  the  enthusiasm  of  some  of  the  writers,  testify  to  the 
value  of  local  treatment  with  electric  incandescent  light. 
Thus  V.  Stein,-)  Gatschkowsky ,^)  Minin,*)  Makaive- 
jezv,^)  Kessler,^)  Turner,'^)  Upcnsky,^)  and  others  (all 
quoted  by  Diuoretzky,''')  )  speak  of  its  good  effect  in  cer- 
tain painful  affections  (lumbago,  rheumatism,  cephal- 
gia, odontalgia,  pleurisy,  pains  in  the  chest  after 
influenza,  etc.).  This  treatment  was  valuable  also  in 
the  case  of  exudations  (rheumatism,  pleurisy,  peritonitis, 
gonorrhoeal  inflammations)  and  in  subcutaneous,  sub- 
periosteal   and    retinal    effusions    of    blood    ( Tichomi- 


0  Even  in  Finscn's  arc-light  treatment,  in  which  recently  no  blue  filters 
have  been  used,  a  curative  action  of  the  long-wave  rays  may  be  possible  under 
certain  circumstances.  This  is  not  especially  the  case  when  the  compressing 
apparatus  is  not  used ;  the  blood  not  being  removed  by  pressure,  the  actinic 
short-waved  rays  are  considerably  checked  in  their  passage  into  the  tissues, 
while  the  long-waved  rays  pass  through  comparatively  freely. 

")   Medizinskoje  Obosrenie,  1890,  Vol.  XXXIII,  p.   1156. 

^)  Russkaja  Medizina,  1892. 

*)  Wratsch,  1899,  Nos.  22,  38,  47;  1900,  Nos.  11,  27. 

'')  Ibid.  1900,  No.  8. 

')  Ibid.  1900,  No.  14. 

'')   Ibid.   1900,  No.  36. 

*)   Russky  Mediz.  Westnik,  1900,  No.   19. 

')   Zeitschr.  f.  diat.  und  phys.  Therapie,  Vol.  V,  p.  3. 


PHOTOTHERAPY  479 

row^)  and  as  a  healing  factor  In  skin  affections 
(ulcerations,  eczema,  lupus,  lepra)  and  in  venereal  and 
syphilitic  affections. 

Minin,  Turner  and  others  claim  to  have  cured  by 
irradiation  from  incandescent  lamps  (16  to  (;o  candle- 
power)  not  only  local  tuberculosis  of  the  bone,  but  even 
general  symptoms  of  tuberculosis  {e.  g.,  night  sweats, 
etc.),  tabes,  scurvy,  sickness.  Kaiser j')  too,  reported 
similar  results.  Possibly,  however,  one  may  be  allowed 
a  little  scepticism  as  to  these  marvellous  results,  seeing 
that  they  are  reported  as  being  obtained  with  treatment 
for  10  to  15  minutes  at  a  time,  repeated  every 
2  to  3  days,  one  lamp  only  being  used. 

The  Electric  Arc-Light. 

§  65.  The  construction  of  arc-lamps  Is  based  on  Davy's  dis- 
covery. In  1 82 1,  of  the  galvanic  arc-light.  If  the  pole  of  a  pow- 
erful galvanic  battery  or  a  dynamo  be  connected  with  two  car- 
bon rods,  a  current  will  be  established  at  once  on  their  contact. 
If  now  they  are  drawn  apart  to  a  distance  of  several  millimetres 
from  each  other  the  current  will  not  be  broken,  but  a  luminous 
arc  will  be  formed  between  the  carbon  points,  along  which  the 
current  passes.  At  the  same  time,  in  consequence  of  the  heat 
developed,  the  carbon  points  will  become  highly  Incandescent, 
hence  their  use  for  })urposes  of  illumination.  The  arc  of  light 
Is  composed  of  gaseous  carbon  and  of  the  vapours  of  metals 
retained  in  the  carbon,  as  the  spectrum  of  the  arc  shows.  In 
lamps  with  alternating  currents  the  carbons  are  consumed 
equally,  and  hence  are  approximately  eijual  in  brilliancy,  giving 
off,  therefore,  a  nearly  equal  amount  of  light  on  both  sides 
(see  Fig.  94)  where  the  length  of  the  radii  bounded  by  the 
curved  lines  corresponds  with  the  strength  of  light  radiated 
in  the  given  directions.  In  lamps  with  a  continuous  current 
the  positive  carbon  glows  more  intensely  than  the  negative  car- 


')   Wratsch.   1900,   No.   11. 

^)   K.  k.   Gcscllschaft  d.   Acrztc  in   Wicn,  Feb.  7,   1902. 


48o 


RADIO-THERAPY 


bons,  being  consumed  about  twice  as  fast  (for  the  resulting 
light  radiation  (see  Fig.  95).  The  carbon  rods  in  lamps  used 
for  lighting  purposes  must  be  kept  at  a  constant  distance  from 
each  other  whilst  the  lamp  is  burning,  in  order  that  the  light 


Fig.  94. 


Fig.  95. 


point  may  be  kept  at  the  same  spot.  Generally  the  carbon 
points,  as  they  gradually  burn  away,  are  adjusted  by  automatic 
regulators. 

In    electric    arc-lamps    the    regulators    are    almost 
always  worked  by  the  magnetic  action  set  up  by  the  cur- 
rent of  the  lamp  itself.    Electric  arc-lamps  are  known 
as  main-current,  shunt-wound  and  differential  arc  lamps, 
according  to  the  winding  of  the  coil  in  the  regulator. 
Lamps  with  hand  regulators  are  sometimes  used  in  photo- 
therapy.  The  light-point  is  further  maintained  in  an  unchanged 
position   by    taking    the    rate    of   combustion    of    each   of   the 
carbon  rods  into  account  when  selecting  their  size.    For  a  con- 
tinuous current  cored  carbons  are  usually  taken  as  the  upper 
or    positive    ones,    homogeneous    carbons    for    the    lower    or 
negative    ones.      As    the    positive    carbon    is    consumed    about 
twice    as    quickly    as    the    negative,    if    both    carbons    are    to 
burn  for  the  same  time,  the  positive  carbon  must  either  be  longer 
or,  as  is  usual,  of  greater  diameter.   With  an  alternating  current 
cored  carbons  are  used  both  above  and  below,  as  they  burn  away 
nearly  at  the  same  rate.      On  the  whole,  thinner  rods  burn  more 
steadily  and  give  better  light  than  thicker  ones,  but  the  latter 
are  often  chosen,  and  are  used  as  thick  as  possible  because  of  the 
longer  time  they  last. 

The  brightness  of  the  electric  light,  of  course,  depends  con- 
siderably on  the  strength  of  the  current.     The  following  table 


PHOTOTHERAPY 


481 


(after  S.  v.  Gaisherg^) )  gives  the  average  illuminating  power 
furnished  by  open  lamps  burning  without  open  shades,  with 
currents  of  different  strength  and  suitable  voltage.  The  table 
gives  further  the  approximate  right  diameter  of  the  carbon  rods 
(for  rods  measuring  together  400  to  500  mm.,  in  length)  if 
they  are  to  burn  fairly  evenly. 


Continuous  Current 

Alternating  Current 

4)  0  l- 

0 

Cored 

Homotteneous 

Carbons 

Average 
Illuminating 

Power 
thrown  down 

0) 

be 
c: 

> 

Lamps  with 

Reflector,  Cored 

Carbons 

•erage 
ninating 
ower 
wn  down 

M      0 

Above 

Below 

Above 

Below 

Amp. 

Volt 

Mm. 

Mm. 

Hefner 
Candles 

Volt 

Afm. 

Mm. 

Hefner 
Candles 

.     2 
3 
4 
6 
8 
10 
12 

15 
20 
25 

38 

39 
40 
40 
40 

41 
42 

■43 
44 
44 

9 
II 

12 

14 
16 

18 
20 
21 
23 

25 

7 
8 

9 

10 
II 
12 
14 
15 
16 

17 

80 

140 

210 

370 

550 

770 

1,000 

1,400 

2,050 

2,800 

28 
29 
29 
30 
30 
31 
32 
32 

7 
8 

9 
10 
II 
13 
15 
16 

"s 

9 
10 
12 
13 
15 
17 
19 

qo 
170 
280 
430 
580 
820 
1,200 
1,600 

The  voltage  given  in  the  above  table  is  deviated  from  in 
certain  kinds  of  lamps  for  which  a  different  material  is  taken 
for  the  carbon  rods  and  a  smaller  light  arc. 

Graetz  assumes  for  his  average  that  an  arc-lamp  with  con- 
tinuous current  gives  light  of  about  100  normal  candle-power 
for  each  ampere  consumed. 

Palaz  gives  the  following  table")  for  various  strength  of 
current.     (See  next  page.) 

The  voltage  necessary  for  establishing  the  arc  is  dependent, 
with  both  continuous  and  alternating  current,  on  the  length  of 
the  arc,  the  kind  of  carbon  used,  the  strength  of  the  current  and 
(with  alternating  current  only)  the  form  of  the  curve.  For  con- 
tinuous current,  with  current  strength  of  6  to  14  amperes  and 


')   Ta.schcnbuch  fiir  Montciirc  elcktrischcr  RcK'ucIitmiijjsanlapcn.  ]\Tiinclicn, 
Leipzig,  1901.  p.   102. 

-)    R.  k'ltliliinnni.  (Iriuidziigc  dt-r  filciclistioiulccknik,  Leipzig,   1901,  p.  59- 


482 


RADIO-THERAPY 


Strength  of 
Current  in 
Amperes 

Average  Spherical 

Strength  of  Light 

in  Decimal 

Consumption  of 

Watts  for  an 

Average  Spherical 

Candles 

Decimal  Candle 

4 

302 

0.  66 

6 

470 

0.64 

8 

650 

0.62 

lO 

840 

0.60 

12 

1,042 

0.58 

14 

1,255 

0.  56 

i6 

1,477 

0-54 

20 

1,960 

0.51 

3° 

3,360 

0.45 

length  of  arc,  2  to  4  mm.  (the  more  usual  numbers),  the  ter- 
minal voltage  would  be  40  to  50  volts  ^) . 

The  illuminating  power  of  the  lamp  depends,  the  strength 
of  current  remaining  the  same.  In  large  measure  on  the  length 
of  the  light  arc.  If  the  distance  between  the  carbon  points  Is 
too  great  the  light  flickers,  becomes  unsteady,  and  often  goes 
out  with  a  loud  noise.  The  length  of  arc  must  always  be  pro- 
portional to  the  strength  of  the  current,  the  number  of  amperes 
which  pass  through  the  lamp.  Graetz  puts  the  right  length  of 
arc  for  lamps  supplied  with  5  to  6  amperes  current  at 
I  to  2  mm.,  for  8  to  10  amperes  at  3  mm.,  and  for  powerful 
lamps  with  20  or  more  amperes  strength  at  4  to  5  mm.  The 
arc-light  may  be  examined  through  smoked  glass,  or  super- 
Imposed  red  and  green  glass. 

As  is  evident  from  Fig.  95,  with  a  continuous  current  lamp 
the  measurable  strength  of  light  varies  very  considerably 
according  to  the  direction  in  which  the  light  falls  on  the  eye  or 
the  photometre.  The  greatest  Illuminating  power  Is  radiated 
at  an  angle  of  40°  to  60°  below  the  horizontal. 

In  H.  W .  VogeV s  -)  experiments  with  a  Siemens'  lamp,  at 
a   nearly   horizontal   position    (1°,   with   a   current  of   8>>4    to 


^)  7.  Herzog  and  C.  P.  Fcldmaiin.  Handl).  d.  elcktr.  Belcuchtung.  Berlin 
and   Mijnchen,    1898,   p.    17. 

°)   Das  Licht  im  Dienste  dcr  Photographic,  Berlin,  1894,  p.  123. 


PHOTOTHERAPY  483 

9  amperes  and  the  use  of  nearly  i  horse-power),  the  light  was 
394  aniyl  candle-power;  at  25^4"  below  the  horizontal 
8>^  to  8^:^  amperes  gave  1043.74  candle-power. 

Thus,  if  the  illuminating  power  of  an  electric  lamp  of  a 
certain  strength  of  current  be  given,  it  is  necessary  to  indicate 
also  the  direction  of  the  radiation. 

Lamps  with  alternating  current  give  approximately 

the  same  amount  of  light  above  and  below.     A  reflector 

Is  usually  placed  Immediately  above  the  arc  to  utilise  the 

light  radiated  upwards,  and  in  this  case  the  brightness 

of  the  alternating  lamp  is  equal  to  that  of  a  lamp  with 

continuous  current;  as  regards  the  actinic  rays,  however, 

there  is  considerable  difference  between  the  two  lamps. 

Alternating  lamps   are   seldom  used  with   a   less   than 

4  amperes  current,  because  of  their  slight  illuminating 

power. 

The  brightness  of  the  different  parts  of  the  spectrum  varies 

quantitatively    (cf.   scale  on  p.   450)    in  the  electric  arc-light 

as  in  sunlight.    This  scale  shows  that  the  blue  rays  preponderate 

greatly  over  the  red  and  yellow  ones  in  electric  light. 

Abney'^)  showed  that  as  the  rotary  movement  of  the 
dynamo-electric  machine  ")  increased  in  speed,  not  only  does 
the  light  as  a  whole  become  brighter,  but  the  intensity  of  the 
more  highly  refrangible  rays  is  increased  disproportionately  to 
that  of  the  less  refrangible  rays. 

This  has  been  confirmed  recently  by  Absolon  Larsen's 
reports  " ) . 

After  direct  sunlight  and  magnesium  light,  no  light  is  so 
effective  chemically  as  an  electric  arc-light.  The  light  of  power- 
ful arc-lamps  acts  on  photographic  bromide  or  iodide  of  silver 
plates  almost  as  powerfully  as  sunlight,  and  decomposes  iodine 
salts    even    more    energetically*).     The    following    figures    of 


')   Edcr's  ausfiihrliches  Handbuch,  I,   i,  p.  466. 

')   On  which  the   strength  of  current  or  clectro-motDr   jxiwim-   depends — 
cf.  p.  99. 

^)   Mittheilungcn   aus  Finscn's  med.   Liclitinslitut,    II,    igor.   p.    1  iS. 

*)  S.  Leeds,  Chem.  News,  Vol.  XLII,  p.  1^7.— User's  Handbuch,  Vul,  1. 


484  RADIO-THERAPY 

Eder's^)  give  its  strength  chemically  as  compared  with  that 
of  sunlight. 

Photographs  of  drawings,  taken  for  purposes  of  comparison, 
were  exposed:  6  minutes  in  electric  arc-light  of  i,8oo  candle- 
power  at  a  distance  of  half  a  metre,  a  white  reflector  being 
used;  2>^  minutes  in  diffused  daylight;  40  seconds  in  direct 
sunlight. 

Prof.  Vogel  gives  another  table  with  reference  to  the  photo- 
graphing of  paintings.  He  arranges  the  different  kinds  of 
light,  as  regards  their  efficiency  for  photographic  purposes,  as 
follows : 

1.  Sunlight  is  8  to  14  times  more  powerful  than  diffused 
daylight  with  a  clear  sky; 

2.  Electric  arc-light  (6  lamps  of  7,000  candle-power 
altogether,  distance  i>4  metres,  with  white  reflector)  is  4  times 
as  powerful  as  daylight  in  November  with  a  clear  sky; 

3.  Then  comes  clear  sky  with  white  clouds; 

4.  Blue  sky; 

5.  Dull  sky  (light  often  only  one-tenth  as  powerful  as  white, 
cloudless  sky) . 

We  need  hardly  point  out  how  fundamentally  important 
for  the  various  forms  of  phototherapy  are  these  thorough  photo- 
metric investigations  of  Eder,  Vogel,  and  others. 

Starting  from  the  assumption  that  the  curative  results  of 
arc-light  treatment  are  due  mainly  to  the  chemical,  and  par- 
ticularly to  the  ultra-violet,  rays,  attempts  have  recently  been 
made  to  construct  sources  of  light  which  should  produce  these 
rays  in  special  abundance.  This  end  was  attained  by  taking  as 
electrode-material,  instead  of  carbon,  metals  and  substances  not 
readily  fusible  (lime,  silicic  acid,  zircon,  thorium,  magnesium 
compounds).  Finsen  hollowed  out  the  positive  electrode  and 
filled  it  with  a  mixture  of  graphite  and  calcined  lime.  Strehel, 
too,  at  the  Dermatological  Congress  in  Breslau  in  1901,^) 
showed  useful  apparatus  for  photo-therapeutic  purposes.    Great 


^)   Photogr.  Mitth.,  Vol.  XX,  p.  39,  quoted  from  Eder's  Handbuch,  p.  465. 
^)  According  to  Drossbach,  Sccchi  used  iron  electrode  arc-lamps  as  long 
ago  as  1873. 


PHOTOTHERAPY 


485 


difficulty  was  found  at  first  in  using  pure  metals  for  electrodes, 
because  the  metal  at  the  ends  of  the  electrodes  is  apt  to  melt 
and  drip,  forming  a  sort  of  bridge  between  the  electrodes  and 
extinguishing  the  light.  I'his  difficulty  was  met  by  Sophiis 
Bangs  iron-electrode  lamp  with  water-cooling  arrangement,^) 
invented  in  1901  (Fig.  96).  This  lamp  is  very  handy  and 
cheap,  and  requires  only  a  weak  ^  ^ 

current  to  produce  a  noticeable 
chemical  effect.  The  principle  | 
of  its  arrangement  is  that  the  \- 
conducting  wires  H  H  are  car- 
ried to  two  electrode  holders 
FF,  fastened  to  the  springs 
K  K ;  changeable  thimble-shaped 
iron  electrodes  EE  are  screwed 
on  to  FF.  The  electrodes  are 
hollow,  and  connected  by  thin  -^ItT^ 
pipes  G,  running  along  the  in- 
side of  the  tube  that  serves  as 
handle,  with  the  water  appa- 
ratus. The  lamp  is  lighted  by 
pressing  the  button  ./  to  let 
the  electrodes  touch  and  then  re- 
leasing the  button  at  once.  It 
is  blown  out  like  any  ordinary 
lamp.  By  the  screw  B  the  dis- 
tance between  the  electrodes  can 
be  altered  and  the  voltage  kept 
sufficiently  constant.  If  the  lamp 
burns  with  8  amperes  and  40 
volts  an  iron  electrode  lasts  on  ^ic.  96.— Iron-electrode  lamp,  by  Dr. 
,  r  ,         •       L  ^-    Bang.     (From   Zcitschr.,   etc.) 

the  average  four  to  six  hours. 

The  lamp  is  provided  with  one  of  Finsen's  quartz  compression 
apparatus;  this  is  fixed  on  the  tube  //  B  C  I)  in  such  a  way  as  to 
be  easily  removable,  either  for  cleaning  or  for  being  exchanged 


')   According  to  Bohr,   IV.  Sicnmts    as    far    back    as    1879    used    metal 
electrodes  cooled  by  water  for  arc-lamps. 


486 


RADIO-THERAPY 


for  pressure  apparatus  of  difierent  shape  and  size.  When  using 
this  apparatus,  one  has  to  bear  in  mind  that  if  the  water-coohng 
apparatus  is  not  effective  little  drops  of  molten  iron  may  form 
on  the  electrodes.    These  drops  must  be  removed  with  a  little 


Fig.  97. — Iron  arc-lamp,  by  Rciiiigcr,  etc. 


wooden  stick  or  they  may  fall  down  and  damage  the  compressor 
or  hurt  the  patient.  The  Kjeldsen  arc-lamp  "Dermo"  is  con- 
structed on  the  same  lines.  Andre  and  Broca,  Chatin,  too,  use 
arc-lamps  having  a  carbon  with  metal  "core"  for  positive  elec- 
trode. 

Reiniger,  Gebbert  &?  Schall's  iron  arc-lamps  (Figs.  97  and 
98)  have  a  convenient  improvement  on  the  Bang  lamp.    In  a» 


Fig.  98. — Iron  arc-lamp  by  Reiniger,  Gebbert  &  Scliall. 

arrangement  similar  to  Bang's,  two  light  arcs  are  used,  put  one 
behind  the  other.  This  not  only  increases  greatly  the  illumi- 
nating power  of  the  apparatus  but  also  works  the  lamp  much 
more  economically,   for  almost  the  entire  energy  of  the  total 


PHOTOTHERAPY  487 

voltage  of  1 10  volts  is  converted  into  two  light  arcs  of  45  volts 
each,  whilst  in  lamps  with  only  one  arc  of  45  volts  more  than 
half  the  energy  used  is  expended  to.  no  purpose  in  overcoming 
resistance.  The  greater  intensity  of  the  light  enables  one  to 
diminish  the  duration  of  the  sitting. 

E.  Rasch  ^)  lately  described  an  arc-lamp  in  which  oxides  of 
the  metallic  earths,  here  called  "electrolyte  electrodes,"  are  used 
as  rods.  To  produce  the  arc  these  rods  have  to  be  made  con- 
ductive by  heating,  which  is  done  by  means  of  an  auxiliary  arc 
between  carbon  electrodes,  arranged  close  to  the  others.  Arc- 
lamps  of  this  kind  are  said  to  be  highly  efficacious,  more  so, 
according  to  the  inventor,  than  any  other  arc-light;  the  light 
is  white. 

The  new  arc-lamp  of  Bremer-)  is  constructed  on  another 
plan.  The  poles  contain  a  mixture  of  carbon  and  fluor-spar; 
it  is  not  necessary  to  heat  them.  The  usual  arrangement  of  the 
rods  one  above  the  other  is  departed  from  in  this  lamp;  they 
are  arranged  side  by  side  at  an  angle  with  each  other;  the  arc 
of  light  directed  horizontally  between  the  carbon  points  is 
turned  downwards  by  the  current,  so  that  it  spreads  out  like  a 
fan.  This  lamp,  too,  is  highly  efficacious;  its  light  looks 
yellow. 

W.  Vedding's  '')  experiments  with  two  Bremer  con- 
tinuous-current lamps,  of  12  and  60  amperes,  with 
44  and  60  volts  respectively,  the  positive  carbons  of 
which  were  made  of  a  calcium  compound,  show  that 
the  smaller  lamp  had  a  maximum  illuminating  power  of 
6,400  candles,  that  the  illuminating  power  was  constant 
below  the  angles  45°  to  90°  to  the  horizontal,  and  only 
then  decreased  towards  the  horizontal  to  1,000  candles. 
The  scond  powerful  arc-lamp  had  4  arc-lights  arranged 
on  the  occasion  of  the  measurement  in  two  rows.  This 
lamp  gave  its  maximum  of  83,000  candles  below  37°. 
The  experiment  showed  further  that  with  this  new 
lamp  three  times  as  much  light  was  obtained  as  in  other 


')  Elcktrotcchn.  Zcitsclir.,  I<"c1).  I4tli.  kjoi. 
*)  Elcktrotcchn.  Zcitsclir.,  April  41I1.  1901. 
';    Iliid.    iQcxj,  part  27. 


488  RADIO-THERAPY 

arc-lamps  with  the   same  expenditure   of  energy.       It 
shewed  advantages  over  the  older  systems  even  when 
alternating  currents  were  used. 
In  both  Rasch's  and  Bremer's  lamp,  no  doubt,  side  by  side 

with  the  effect  of  the  glowing  electrode  tips,  a  considerable  part 

is  played  by  the  gaseous  metal  compounds  glowing  in  the  arc. 

The  noxious  vapours  given  off  by  these  lamps  may  probably 

stand   in  the  way  of  their  being  used   for  photo-therapeutic 

purposes. 

The  arc-light  in  a  non-concentrated  form  is  used  for  electric 

light-baths,  in  a  concentrated  form  for  the  treatment  of  localised 

skin  complaints. 

The   Therapeutic   Use  of  Non-concentrated  Arc-light. 

§  66.  Arc-light  baths  form  a  quite  distinct  class  of  electric 
light  baths.  Whilst  in  the  incandescent  light-baths  the  long-waved 
rays  (heat  rays,  reddish  yellow)  come  chiefly  into  play,  in  the 
arc-light  baths  the  whole  body  is  exposed  mainly  to  the  chemical 
light  rays.  The  heating  action  of  this  light  is  quite  subordinate 
here  to  its  chemical  action.  Superior  to  them  both  is  the  natural 
bath  in  sunlight,  where  both  the  heat  rays  and  the  actinic  rays 
act  powerfully  on  the  body.  It  is  necessary,  therefore,  to  take 
account  of  the  special  characteristics  of  the  various  light-baths 
when  judging  which  symptoms  point  to  any  particular  method. 

Arc-light  baths  are  taken  either  in  the  open  or  in  a  chamber. 
Finsen  ^)  administers  them  in  the  open  as  follows:  Two  huge 
arc-lamps,  of  lOO  amperes  each,  hang  In  the  middle  of  a  circu- 
lar room  a  few  metres  from  the  ground.  Compartments  are 
formed  round  the  room  by  a  number  of  radial  partitions,  and 
in  them  are  inclined  couches,  turned  towards  the  light,  on  which 
the  patient  lies  naked.  The  temperature  in  these  light-baths 
is  so  low  that  artificial  heat  has  to  be  applied  to  keep  the  patient 
from  feeling  cold,  and  yet  the  chemical  action  on  the  skin  is 
as  powerful  as  in  strong  sunlight.  They  produce  a  pleasant, 
slightly  prickly,  and  feebly  warming  sensation  in  the  skin.  Some 
persons  after  only  ten  minutes  show  distinct  erythema,  whilst 


\)   Uebcr  d.  Bedeutg.  d.  chem.  Lichstr.,  p.  71. 


PHOTOTHERAPY  489 

others  are  able  to  stay  in  the  baths  for  hours  without  more 
than  v^ery  slight  erythema  appearing. 

The  arc-light  "enclosed  baths"  of  Kellogg)  are  quad- 
rangular boxes  in  which  the  patient  sits  with  his  head  outside, 
as  in  the  incandescent  light-baths.  A  powerful  arc-lamp  is 
fitted  in  each  corner,  capable  of  being  turned  both  upwards  and 
downwards,  so  that  the  rays  can  be  directed  on  the  patient  in 
any  position.  Arrangements  are  made  for  the  introduction  of 
coloured  glass  filters  to  obtain  at  will  either  red  light  or  blue 
light,  according  as  the  heat  rays  or  chemical  rays  are  to  be 
excluded. 

Strebel  -)  brings  forward  the  well-founded  objection  to  the 
use  of  arc-lamps  for  enclosed  bath,  that  in  order  to  produce  a 
chemical  effect  about  equal  indegree  to  that  of  diffused  daylight 
they  develop  such  tremendous  heat  in  the  box  that  the  patient 
can  only  stay  In  the  bath  for  a  limited  time,  however  good  the 
ventilation  may  be. 

The  use  of  reflectors  to  intensify  the  light  has  been  the 
objection  that  burn-blisters  are  liable  to  be  formed  on  those 
parts  of  the  skin  on  which  the  concentrated  cone  of  light  and 
heat  falls.  Another  drawback  to  this  use  of  electric  arc-light 
Is  the  formation  of  noxious  gaseous  products  (acetylene  and 
other  compounds  of  carbon  and  hydrogen),  which  are  not  only 
absorbed  by  the  skin,  but  also,  escaping  at  the  neck  opening, 
may  penetrate  the  patient's  air-passages   {Strebel). 

From  these  considerations  it  is  evident  that  the  Finscn 
method  is  the  more  suitable  for  electric  arc-light  baths.  The 
chemical  effect  of  this  arc-light  treatment  might  be  considerably 
heightened  by  the  use  of  parabolic  reflectors,  which  w^ould 
reflect  the  otherwise  wasted  light  which  is  radiated  upwards. 
The  Irradiation  thus  utilized  has  considerably  more  actinic 
power  than  concentrated  light,  without  the  disadvantages  we 
have  mentioned.  According  to  //.  U^.  Vogel;')  a  Schiickert 
reflector  (in  which  not  only  the  parabolic  reflector  but  also  a 


^)   Bliitter  f.  klin.  Ilydrothcrapic,  X.  Jalirg.,  p.  14. 

*)   Die  Verwcndung  dcs  Lichtes  in  der  Thcrapic,  Miinchcn,  1002.  p.  20. 
')  H.   W.   Vogel,  Das  Licht  im  Dicnste  dcr  Photographic,   Berlin    1894, 
p.  123. 


490  RADIO-THERAPY 

system  of  cylindrical  lenses  are  used,  with  the  result  that  the 
reflected  rays  are  even  divergent)  with  60  amperes  strength 
of  current  produced  a  black  photographic  reproduction  in 
15  seconds,  whilst  daylight  in  November  required  2>4  to 
3  minutes  ^) . 

It  is  necessary  with  every  kind  of  arc-light  treatment  to 
bear  in  mind  the  specifically  physiological  effect  of  the  so-called 
chemical  light  rays  (the  peculiar  and  lasting  irritation  of  the 
skin  [Finsen,  M oiler],  the  action  on  the  blood  [Finsen  and 
others,  cf.  p.  412],  also  the  as  yet  uncertain  influence  on  the 
nervous  system)  and  to  judge  accordingly  the  symptoms  point- 
ing to  its  use. 

Arc-light  baths  are  often  combined  with  incandescent  light 
by  introducing  incandescent  lamps  on  the  sides  of  the  bathing 
box;  by  this  means  the  effects  of  the  two  kinds  of  light  are 
united  in  one  apparatus. 

We  have  as  yet  no  precise,  full  and  suggestive  accounts  of 
the  therapeutic  results  of  this  light-bath  method,  but  we  may 
assume  that  light  by  strengthening  the  organism  and  furthering 
the  process  of  phagocytosis  in  the  elimination  of  micro- 
organisms and  toxins  will  give  us  a  remedy  against  many  dis- 
eases. 

Metal  electrode  lamps  have  been  recommended  for  the 
treatment  of  circumscribed  skin  affections.  They  are  used 
similarly  to  the  light  concentrating  apparatus. 

Treatment  with  Concentrated  Arc-light. 

§  67.  The  idea  of  using  concentrated  electric  arc-light  in  the 
treatment  of  skin  diseases  was  brought  into  practice  by  Niels 
Finsen.  His  apparatus  in  the  first  place  makes  the  divergent 
rays  from  the  arc  parallel  (just  in  the  same  way  as  did  the 
appliance  used  by  Widmark  in  his  experiments) .  These  parallel 


^)  Strchcl  in  his  recent  interesting  work.  "Die  Verwendung  des  Lichtes 
in  der  Therapie"  (Miinchen,  Seitz.  u.  Scbauer,  1902),  states  that  he  has  been 
led  by  the  same  conclusion  of  which  Foveau  de  Conrmcllcs,  the  present  writer, 
and  many  other  coUeagues,  arrived  quite  independently,  to  use  refracted  arc- 
light  in  place  o-f  a  sun-bath  in  his  practice,  and  has  done  so  with  good  results. 


PHOTOTHERAPY 


491 


rays  Fiuscu  collects  again  into  a  cone,  the  apex  of  which  falls 
on  the  part  of  the  skin  to  he  treated  (Fig.  99) . 

In  physical  and  medical  laboratories  precisely  similar  appa- 
ratus has  long  been  in  use  which  made  the  divergent  ravs  from 
the  electric  arc  first  parallel  and  then  again  convergent,  and 
filtered  the  heat  rays  through  layers  of  water.     Thus,  in  the 


^^ 


a=5 


Fig.  gg. — Finscn's  light  apparatus. 


Vienna  Institute  for  experimental  pathology  (Prof.  Paltauf, 
and  formerly  Prof.  Strieker),  an  apparatus  constructed  pre- 
cisely like  Finseu's  has  been  used  for  many  years  to  project 
light. 

Finsen  uses  as  his  light  source  an  arc-lamp  of  80  amperes 
with  continuous  current  only;  he  computes  its  light  Intensity  at 
40,000  candles. 

The  voltage  of  powerful  continuous  current  lamps 
of  this  kind  is  at  the  terminals  of  the  lamp  hardly  more 
than  half  the  voltage  of  the  ordinary  current  in  the 
street.  If,  therefore,  the  lamp  were  to  be  attached 
directly  to  a  supply  of  iio  and  more  volts  over  50% 
of  the  electric  energy  would  be  lost  In  the  resistance 
coils  ^).  The  setting  up  of  two  lamps  of  this  kind, 
one  behind  the  other,  is  in  practice  inadvisable  on 
account  of  their  unsteady  action.  Neither  does  the 
supply  allow  of  such  strong  currents  being  taken   from 


')  Naturally  a  supply  of  this  kind  would,  on  account  of  the  large  amount 
of  energy  consumed,  he  much  dearer  tlian  a  current  of  only  llie  reipured 
voltage. 


492  RADIO-THERAPY 

it,  on  account  of  the  strain  involved  on  single  cables 
and  the  resulting  fluctuations  in  voltage  for  other 
neighbouring  consumers  connected  with  the  same  street 
cable.  For  this  reason,  when  such  powerful  arc-lamps 
are  used  with  a  street-voltage  of  more  than  65  volts,  a 
transformer  has  to  be  employed  to  transmute  driving 
voltage  of  the  electrical  supply  to  the  required  lamp 
voltage,  including  the  steadying  resistance. 

Alternating   current   lamps   of   the   same   great   in- 
tensity  of   light    act   unsteadily,    and   it   is    difficult   to 
concentrate  the  light  with  them;  hence  for  these  pur- 
poses alternating  current  lamps  are  not  used. 
The  connecting  apparatus  (Fig.  99)   consists  of  two  metal 
cylinders  telescoped  one  in  the  other,  each  containing  two  plano- 
convex lenses.     The  two  parts  of  the  apparatus  may  be  sepa- 
rated by  means  of  a  rack-and-pinion  movement.     The  various 
lenses  are  in  Finscn's  apparatus  so  proportioned  as  to  size  that 
lenses  i  and  2  have  together  a  focal  distance  of  12  cm.,  lenses 
3  and  4  together  a  focal  distance  of  10  cm. 

The  two  lenses,  i  and  2,  nearest  to  the  source  of  light  col- 
lect the  diverging  rays  of  the  arc-lamp  into  a  bundle  of  parallel 
rays.  Lenses  3  and  4  make  these  parallel  rays  converge  on  the 
surface  to  be  irradiated.  Between  lenses  3  and  i  is  a  water 
chamber  ^)  for  the  purpose  of  absorbing  the  heat  rays.  As  the 
water  in  this  chamber  becomes  heated  when  the  lamp  is  in  use, 
means  are  taken  to  keep  it  constantly  replaced  by  cool  water. 
This  is  done  by  a  system  of  tubes  (one  part  bringmg  the  cold, 
the  other  carrying  off  the  heated  water)  in  connection  with  the 
water  supply. 

At  first  Fiusen  used  glass  lenses  and  distilled  water,  and 
fixed  light  filters  consisting  of  glasses  filled  with  a  solution  of 
sulphate  of  copper  at  the  end  of  the  aparatus  turned  towards 
the  patient.  Now,  in  order  to  lessen  the  risk  of  absorption  for 
the  ultra-violet  rays,  no  colour  filters  are  used,  and  instead  of 


')  According  to  Rcyn's  suggestion,  the  water  chamber  is  now  fixed  be- 
tween the  lenses  turned  towards  the  lamp,  so  that  they  may  be  cooled  and 
their  constant  cracking  avoided  (Quoted  A.  Hubcr,  Der  heutige  Stand  der 
FjM.yen-Therapie,  Wiener  Med.  Wochenschr.,  1902,  No.  20  ff.) 


PHOTOTHERAPY 


493 


the  strongly  absorbing  glass  lenses  only  quartz  lenses.  A  con- 
siderable part,  however,  of  the  effective  energy  radiated  from 
the  arc  of  light  is  still  lost  on  passing  through  the  layer  of 
undisturbed  fluid,  and  the  unavoidable  use  of  several  lenses 
weakens  the  force  of  the  rays  which  arc  allowed  to  pass. 

Four  of  these   collecting  apparatus   are   usually   arranged 
round  the  arc-lamp  (Fig.  loo),  which  is  either  suspended  from 


Fig.   100. — Finscn's  apparatus. 


the  ceiling  or  mounted  on  a  high  iron  stand.  The  spaces  between 
the  smgle  concentrators  are  filled  with  asbestos  plates,  so  that 
the  operator  and  the  attendants  may  not  be  incon\enienced  by 
the  strong  light.  By  means  of  this  arrangement  four  patients 
can  be  treated  at  once  and  the  expensive  light  be  fully  utilised. 

The  light  from  this  concentrating  apparatus  not  being  even 
yet  suflicicntly  cool  to  be  borne  without  discomfort  for  any 
length  of  time  on  the  skin,  Finscii  hit  upon  a  very  usclul  )il;in. 
A  compressor,  consisting  of  two  quartz  discs  fixed  in  a  brass 
ring,  is  pressed  on  the  irradiated  spot;  through  this  apparatus 
a  constant  circulation  of  cold  water  is  maintained  by  means  of 


494  RADIO-THERAPY 

a  suitable  system  of  tubing^).  This  arrangement  does  away 
with  what  is  left  of  the  heat,  and  by  the  continuous  pressure 
on  the  irradiated  skin  it  serves  the  further  important  purpose 
of  making  the  skin  anaemic.  This,  as  Finsen  has  shown 
(cf.  p.  426),  enables  the  actinic  rays  to  penetrate  far  more 
deeply. 

This  pressure  apparatus  is  fixed  to  the  patient's  body  with 
bandages,  or  may  more  conveniently  be  held  on  with  the  hand. 

Betirmann  drives  the  blood  out  of  the  irradiated  parts  by 
applications  of  adrenalin  (1:1000),  which  constricts  the  ves- 
sels -).  But  the  author's  experiments  go  to  show  that  adrenalin 
only  acts  thus  when  first  applied;  the  effect  soon  lessens. 

As  has  been  said,  Finsen  replaced  by  quartz  lenses  the  glass 
ones,  by  which  ultra-violet  is  so  strongly  absorbed.  But  that 
had  the  further  disadvantage  of  necessitating  the  use  of  lenses 
of  small  diameter  (7-8  cm.)  only,  for  quartz  lenses  of  greater 
diameter  are  hard  to  get  and  very  costly.  The  light  from  the 
voltaic  arc,  however,  can  be  utilised  to  a  comparatively  slight 
extent  with  small  lenses.  In  this  respect  metal  reflectors  act 
better.  Foveaii  de  Courmelles,  Troiive^)  Kime,'^)  J.  G. 
MiiUer,-')  Strehel  and  others,  therefore,  proposed  to  have  appa- 
ratus with  mirrors  instead  of  lenses.  Strehel  described  the  con- 
struction of  a  concentration  apparatus  in  which  the  rays  are 
concentrated  by  metal  mirrors  of  magnalia,  an  alloy  of  alumin- 
ium and  magnesium.  These  mirrors,  according  to  F.  Schu- 
mann,^) reflect  not  only  the  visible  spectrum  but  also  the  ultra- 
violet rays  satisfactorily.  The  light  falls  on  four  magnalia 
concave  mirrors')   mounted  in  a  metal  frame  at  an  angle  of 

')  In  the  accompanying  figure  the  water-supply  of  the  compressor  is  rep- 
resented, for  simplification  of  the  drawing,  as  coming  from  the  cooling  water 
of  the  concentrating  apparatus.  In  practice,  however,  each  of  the  two  appa- 
ratus has  its  own  two  pipes  to  the  water-supply. 

")    Soc.  de  dermatologie  et  de  syph.,  July  3rd,  1902. 

■*)   See  below. 

*)   Medical  Record,  Oct.  13th,  1900. 

^^)  VII.  Dermat.  Congr.,  Breslau,  1901. 

")  L.  Mach  and  V.  Schumann,  Ein  neues  Spiegelmetall.  Sitzungsher.  d. 
kais.  Akad.  d.  Wissensch.,  Math.-naturw.  CI,  1899. 

')  Other  metals  too  might  l)e  suitable  for  such  reflectors,  e.  g.,  steel  and 
the    Brandcs-SchmemQnn    alloy     (41%  Cu  +  26%  Ni  +  24%  5n  -f  8%  Fe 


PHOTOTHERJPY 


495 


45°  round  the  arc-light.  They  project  their  light  through  a 
cooling  apparatus  fitted  with  piano-parallel  plates  or  suitahly 
curved  lenses.  To  protect  the  polish  of  the  mirror  from  the 
destructive  effect  of  the  ozone,  sometimes  provision  is  made 
for  a  stream  of  water  to  run  over  the  mirror-surface/)  or  the 
metal  is  cooled  from  the  back  (Fig.  loi). 

The  author  is  not  aware  if  such  apparatus  has  actually  been 
made,  or  how  it  acts  in  practice. 


Fig.   ioi. — Strcbcl's  Light  Apparatus. 


According  to  a  fundamental  law  of  optics  (cf.  p.  372), 
the  intensity  of  light  varies  inversely  with  the  square  of  the 
distance^      Hence  we  should  expect  to  heighten  the  effect  of 


-f  1%  Sb),  the  latter  of  which,  according  to  Glatzcl  (Pliysik.  Zcilschr., 
1900,  Vol.  II,  p.  176),  takes  a  very  good  polish  and  resists  the  action  of  the 
air.  Both  are  very  well  adapted  for  photographic  purposes.  Silver  mirrors 
reflect  92%  of  the  visible  spectrum,  the  Bnindcs-Schuncviaun  alloy  only  50%  ; 
but  the  latter  reflects  ultra-violet  more  than  other  metals. 
')   Which  probably,  however,  destroy  the  ultra-violet. 


496 


RADIO-THERAPY 


irradiation  by  bringing  the  source  of  fight  as  close  as  possible 
to  the  object  to  be  irradiated.  (  The  lazv  holds  good,  indeed, 
only  for  non-concentrated  light;  with  concentrated  light  the 
distance  is  not  of  such  great  importance.)  This  law  is  observed 
by  the  metal  electrode  lamps  already  described,  as  well  as  by 
the  apparatus  designed  by  Foveau  de  Courmelles  and  Lortet 
and  Genoiid.  Being  designed  with  due 
heed  to  this  principle,  these  apparatus 
have  the  advantage  of  not  requiring 
so  extraordinarily  powerful  a  source  of 
light,  or  so  strong  a  current,  as 
Finsen's  concentrating  apparatus;  and, 
further,   the   absorbing  media   are   in 


Figs.  102,  103. — Apparatus  by   Tronve-Fovcau  dc   Courmelles. 

them  reduced  proportionately  in  size.  Consequently  the  action 
with  these  apparatus  is  very  intense,  and'the  time  of  exposure 
can  be  considerably  diminished. 

Foveau  de  CournicUes  and  Troiive's  apparatus  consists  of  a 
parabolic  mirror,  in  the  focus  of  which  is  the  arc-light  of  a 
lamp  of  10  to  12  amperes  (Figs.  102  and  103).  Suitable  filters 
are  fixed  at  the  opening  of  the  reflector,  according  as  light  rays 
or  heat  rays  or  both  are  desired.   The  heat  filter  consists  of  two 


PHOTOTHERAPY 


497 


quartz  discs,  2  to  8  mm.  apart,  between  which  a  layer  of  cold 
water  circulates.  These  two  discs  may  be  of  various  shapes  and 
sizes,  and  are  applied  directly  on  the  part  to  be  irradiated,  act- 
ing as  a  pressure  apparatus  at  the  same  time  ^). 

At  a  meeting  of  the  Soc.  Franc,  de  Dermatolog.  et  Syph. 
on  May  ist,  1902,  Du  Castel  reported  that  he  had  found  this 
apparatus  to  act  admirably  in  the  treatment  of  lupus. 

Du  Castel  gained  strikingly  good  results  with  the 
Fovcaii-Tr Olive  apparatus  In  the  case  of  two  patients, 
giving  65  and  40  one-hour  sittings  respectively,  with  a 
current  of  6  amperes.  He  believes  that  the  length  of 
treatment  each  time  is  an  essential  factor  in  the  cure,  and 
never  now  has  a  sitting  of  less  than  an  hour. 
With  Lortet  and  Genoiid's  apparatus.  Fig.  104  (L'Tnde- 
pendance  medicale,   March  27th,    1901),  a  constant  arc-light 

D 


Fig.   104. — Apparatus  by  Lortet  and  Gcnoud. 


is  produced  between  two  carbon  points  which  form  so  great 
an  angle  that  the  crater  of  the  positive  carbon  radiates  the 
greater  part  of  the  light  in  the  shape  of  a  cone,  whose  axis 
passes   through   the   centre   of   the   opening   O.     This   opening 


')  According  to  Povcaii  dc  Couniirllrs  (  I>ullelin  office  dc  la  Soc.  nicd.  dis 
Practicien.s,  11  Ann.,  June  15,  1901,  No.  6),  G.  Trouvc  lias  from  iS^.^i  used 
parabolic  mirrors  to  strengthen  the  therapeutic  action  of  light. 


498  RADIO-THERAPY 

forms  the  centre  of  a  curved  metal  light-screen  D  D,  between 
the  double  walls  of  which  cold  water  is  kept  constantly  cir- 
culating. 

A  small  mirror  M  prevents  any  light  from  being  radiated 
backwards,  so  that  almost  all  falls  in  front. 

A  system  of  screws  and  slides  enables  the  arc  to  be  regulated 
and  advanced  more  or  less  near  to  the  opening.  When  the 
apparatus  is  working  the  carbons  are  brought  to  within  i  or  2  cm. 
of  the  opening.  In  front  of  this  is  a  chamber  consisting  of  two 
rock  crystal  discs  set  in  a  metal  ring;  in  this  chamber  a  stream 
of  water  circulates.  This  chamber  constitutes  the  compressor. 
Experience  shows  that  the  arc-light  may  be  approached  to 
within  3  to  4  cm.  of  the  chamber  without  the  latter  being 
heated.  The  heat  rays  in  this  apparatus  are  well  absorbed. 
The  size  of  the  part  irradiated  may  be  as  much  as  6  cm.  The 
lamp  is  said  to  require  not  more  than  10  to  12  amperes.  The 
time  of  illumination  for  therapeutic  purposes  is  given  as  10  to 
15  minutes  ^) . 

The  most  important  use  of  all  these  apparatus  is  for 
Finsen's  treatment  of  lupus  vulgaris.  This  Is  applied  as  fol- 
lows: Each  patient  has  his  own  attendant  whose  business  it  is 
to  direct  the  light  constantly  on  the  diseased  spot.  The  patient 
lies  on  a  suitable  couch  with  his  head  raised,  or  sits  in  an  arm- 
chair with  a  head-rest.  (The  patient  would  hardly  be  able  to 
keep  immovable  for  a  long  time,  say  two  hours,  in  a  sitting 
position.)  His  eyes  are  protected  by  a  cloth,  the  attendant's  by 
darkened  glasses.  Any  scabs  or  crusts  there  may  be  are 
removed,  having  been  previously  softened,  with  forceps,  and 
the  part  Is  washed  with  a  weak  antiseptic  solution  (3%  boracic) 
and  dried.  Now  the  light  cone  is  directed  on  to  the  site  of 
disease,  and  care  is  taken  that  the  axis  of  the  light  cone  Is 
perpendicular  to  the  area  illuminated;  the  part  to  be  treated  Is 
not  placed  directly  at  the  focus,  but  a  little  in  front  of  It  so 
that  not  one  point  but   a   small  circle   is   illuminated.      This, 


^)  Fovcau  dc  Conrincllcs,  however,  asserts  (L'annee  electr.,  1902,  p.  354) 
that  with  this  apparatus  a  supply  current  of  20  to  25  amp.  and  sittings  of 
one-quarter  to  half  an  hour  proved  necessary.  The  unshaded  light,  too,  in 
the  apparatus  might  be  troublesome  to  the  operator. 


PHO  TO  THERAPY  499 

moreo\er,  helps  to  prevent  the  skin  from  being  heated.  A 
circular  area  having  a  diameter  of  2  cm.  may  be  treated  at 
one  sitting.  The  surrounding  parts  are  covered  with  wadding 
or  yellow  paper. 

Now  a  suitably  shaped  compressor')  Is  placed  on  the 
diseased  spot  and  held  there  firmly  with  equable  pressure.  The 
duration  of  the  sitting  varies  according  to  the  quality  and 
Intensity  of  the  light  used.  Fiuscn  recommends  a  two  hours' 
exposure  with  his  concentrator  and  a  lamp  of  30  amperes;  with 
lamps  of  80  amperes  the  time  may  be  cut  down  to  an  hour,  or  an 
hour  and  a  quarter.  With  these  powerful  lamps,  Finscn,  after 
only  13  to  20  minutes'  continuous  Illumination,  effected  a  definite 
cure  of  lupus  nodules  the  size  of  peas.  The  designers  of  the 
newer  kinds  of  apparatus  {Foveau,  Lortet,  Ban^,  Strcbcl)  give 
the  necessary  time  of  exposure  for  their  instruments,  on  account 
of  the  greater  light  intensity — that  is,  the  greater  proportion 
of  ultra-violet  rays — as  10  to  20  minutes.  The  treatment  con- 
sists of  one  sitting  a  day,  except  In  cases  where  the  morbid 
growth  is  very  extensive,  when  two  a  day  are  given. 

The  patient  suffers  no  pain  during  the  Irradiation,  except 
perhaps  when  the  pressure  is  applied  to  ulcerated  or  bony  parts, 
e.  g.,  near  the  nose. 

After  the  treatment  symptoms  of  erythema  solare  appear, 
the  Irradiated  part  becomes  a  little  red,  the  redness  very  soon 
increases  markedly,  and  at  the  same  time  slight  swelling  shows 
itself  and  burning  pains  are  felt,  the  skin  becomes  softer  and 
unevennesses  disappear.  Often  24  to  48  hours  later  a  large 
blister  forms,  filled  with  serous  fluid;  this  dries  away  in  6  or 
8  days  to  small  readily-removable  scabs.  There  Is  nc\er  any 
loss  of  substance  below  the  blister. 

When  the  blister  has  exfoliated,  considerable  redness  Is  left, 
which  only  passes  away  after  months. 

To  prevent  Infection  of  the  blisters  a  dressing  Is  applied  of 
boracic  lotion  or  zinc  ointment.  After  a  week  or  fortnight, 
when  the  reaction  has  disappeared  and  the  scabs  have  fallen  oft. 


')  For  the  skin  of  the  chcclc,  which  yii-lds  readily  Id  pressure,  the  com- 
pressors used  arc  convex,  for  the  forehead  concave,  and  for  tlie  temples  plane. 
{Finscn,  Sriiinidl.  Berliner  klin.  Wochcnschr.,  1901,  No.  .3_'.) 


500  RADIO-THERAPY 

the  same  place  may  be  Irradiated  again,  later  even  more  than 
once;  in  fact,  this  is  necessary  if  the  therapeutic  effect  is  to  be 
lasting.  When  one  spot  seems  to  have  been  sufficiently  treated 
a  neighbouring  spot  is  treated  in  the  same  manner.  In  this  way 
the  treatment  proceeds  from  spot  to  spot,  until  the  whole  part 
attacked  has  been  exposed  to  the  influence  of  the  light.  The 
treatment  should  begin  at  the  periphery  of  the  lupus  region,  and 
the  light  must  be  so  directed  that  in  each  area  of  illumination 
a  piece  of  the  apparently  healthy  skin  in  the  immediate  neigh- 
bourhood is  also  included. 

After  the  sitting  the  spot  is  marked  round  with  a  pencil  and 
so  indicated;  then  the  dressing  is  applied.  The  compressor, 
having  been  cleansed  with  ether,  alcohol,  and  a  solution  of 
carbolic,  must  be  steeped  for  an  hour  in  carbolic  and  then  placed 
on  the  side  filled  with  distilled  water.  The  rock-crystal  lenses 
of  the  concentrators  are  cleaned  once  or  twice  a  week  with 
ordinary  water  and  afterwards  rubbed  with  cork;  those  near- 
est to  the  carbon  points  are  further  brushed  down  thoroughly 
after  each  sitting  and  covered  with  flannel  caps  to  prevent  too 
rapid  cooling  and  consequent  cracking  [Schmidt) . 

When  a  patch  of  lupus  has  been  sufficiently  treated  the 
nodules  and  the  raised  edges  of  the  lesions  become  flattened; 
where  formerly  confluent  nodules  formed  continuous  lupous 
infiltrations  appear  now  isolated  nodules  with  strips  of  healthy 
skin  between.  By  degrees  these  isolated  nodules  also  disappear; 
the  light  reaches  not  only  the  superficial  but  also  the  deeper 
lying  ones.  Ulcers  grow  less  both  in  surface  extent  and  in 
depth,  and  cicatrise.  The  redness  of  the  skin  gives  place  to 
normal  colouring.  The  cosmetic  result  as  regards  the  appear- 
ance of  the  scars  is  excellent.  The  scars  are  smooth  and  soft, 
the  losses  of  substance  are  slight  and  only  such  as  arose  from 
the  morbid  processes,  not  from  the  treatment,  which  does  not 
affect  the  normal  tissues. 

Gaston^  Baiidoii'in  and  Chalin  report  hypertrophic 
and  keloid  scars,  as  well  as  smooth  scars,  "in  several  cases 
healed  by  means  of  the  Lortet-Genoud  apparatus  ^). 


^)   Soc.  de  dermatolog.,  April  i,  1902. 


PHOTOTHERAPY  501 

F'uisens  treatment,  beginning  as  it  properly  does  at  the 
periphery  and  taking  in  always  the  neighbouring  healthy  skin, 
has  the  effect  at  once  of  checking  the  spread  of  destructive 
lupous  processes.  The  action  of  the  light  on  lupus  is  not  only 
an  immediate,  but  also  a  lasting  one,  going  on  even  after  the 
treatment  has  stopped.  Suspicious  spots  have  often  been  known 
to  resume  a  healthy  appearance  during  the  course  of  several 
months  after  treatment  with  the  rays  has  been  suspended. 
Finsen  concluded  from  this  that  the  tubercle  bacilli  are  killed 
by  the  light  In  a  much  shorter  time  than  Is  required  for  the 
slow  process  of  transforming  the  diseased  reddish-brown  tissue 
into  healthy  skin  of  a  normal  colour. 

It  seems  to  the  author  doubtful  whether  this  bactericidal 
power  of  light  is  really  the  essential  curative  force  in  this 
treatment.  He  would  rather,  with  S.  Bang,^)  G.  J.  Miiller,^) 
Glebozvsky,  Serapin,  Sack  (cf.  below)  and  //.  E.  Schmidt/^) 
lay  stress  on  the  action  of  the  light  in  producing  inflammation. 
Light  seems  to  him  to  act  as  an  irritant  penetrating,  like  the 
Roentgen-rays,  very  deeply.  Its  action  goes  deeper  than  that 
of  many  chemical  irritants,  e.  g.,  pyrogallic  acid,  resorcin  and 
lactic  acid,  the  effect  of  which  Is  weakened  by  the  albumen  com- 
pounds soon  formed.  The  light  irritant  stimulates  the  granu- 
lation tissue,  which  is  usually  but  little  inclined  to  change  into 
connective  tissue,  to  the  formation)  of  connective  tissue  and 
cicatrices.  Probably  the  extraordinarily  powerful  illumination 
acts  on  the  diseased  tissues,  which  are  specially  sensitive  to 
light  and  less  able  to  resist  its  action,  as  a  hyper-irritant,  and 
this,  as  is  well  known,  kills  the  cells.  By  this  means  the  morbid 
tissues  are  destroyed  and  prepared  for  reabsorptlon. 

There  Is  a  further  circumstance  which  may  make  for  the 
favourable  action  of  light,  viz.,  the  artificial  and  lasliug  hyper- 
asmia  produced  by  it  in  the  diseased  area.  We  know  that  in 
the  treatment  of  various  tuberculous  processes  hypcr;emia  has 
been   aimed   at   again   and   again,    and    that   good    therapeutic 


')   VII   Congr.  (1.  (Ictitsch.  dc-niiatol.  Ck'.^cllscli.,  Bicslau,   igoi. 

')   Ibid. 

')    Berlin,  klin.   Woclienschr.,    upi.  No.  32. 


502  RADIO-THERAPY 

results  have  thereby  been  gained.  We  need  mention  here  only 
Biers  treatment  of  tuberculous  affections  of  the  joints,  with 
which  in  this  respect  we  may  compare  the  action  of  the  old 
Koch  tuberculin  [Neisser,  Scholtz),  and  that  of  the  penetrating 
chemical  caustics,  pyrogallol,  resorcin  {Ehrmann) ,  and  lactic 
acid    {Max  Joseph). 

As  the  result  of  this  hyperaemia  the  chemical  products  of 
the  bacteria  are  said  to  be  accumulated,  a  circumstance  which 
is  inimical  to  the  bacteria  themselves;  Bier  holds  further  that 
hyperemia  promotes  the  formation  of  connective  and  scar 
tissues  ^). 

Light,  in  the  author's  opinion,  acts  iri  the  case  of  all  such 
affections  exactly  in  accordance  with  the  action  which  all  physi- 
ological irritants,  following  a  universal  law,  exercise :  it  acts 
partly  as  a  stimulus  and  partly  as  a  strong  irritant,  paralysing 
and  destroying.  He  recognises  in  these  rays,  as  in  the  Roent- 
gen-rays, just  those  kinds  of  irritants  which  have  a  specific  action 
and  are  of  special  therapeutic  value : 

1.  Because  of  the  specific  quality  of  the  rays; 

2.  Because  of  their  power  of  penetrating  deeply. 

The  latter  quality  is  specially  important  in  treating  deeply- 
lying  granulomata,  for  the  other  remedies,  such  as  copper 
sulphate,  camphor,  etc.,  which  have  been  used  for  ages  to 
stimulate  torpid  granulations,  ulcers,  and  wounds  to  the  forma- 
tion of  connective  tissue  and  scars,  have  only  a  superficial 
action. 

Glebowsky    made   a    histological  study   of   the   process   of 


0  Since  the  compressor  drives  away  the  blood  from  the  diseased  spot  dur- 
ing the  treatment,  and  thus  tends  to  prevent  the  hyperaemia  aimed  at,  E. 
Lang's  theory  as  to  the  pressure  of  the  capsule  being  an  essential  curative  fac- 
tor seems  to  the  author  unfounded.  His  assertion  (Wiener  dermatolog.  Ge- 
sellschaft  and  IV  Internat.  Congr.  f.  Dermatologie  und  Syph.,  Aug.  1900, 
Compt.  rend.,  p.  171)  that  he  cured  lupus  by  pressure  with  the  lens  alone  is 
quite  unique  and  has  not  been  confirmed.  On  the  contrary,  G.  J.  Mullcr 
reports  (VII  Congr.  der  deutschen  dermatolog.  Gesellschaft,  Breslau,  Ver- 
handlungensber,  p.  471)  that  he  found  no  result  from  glass  pressure  tried 
experimentally  for  weeks  for  as  much  as  eight  hours  at  a  time,  but  that  a 
distinct  effect  was  noticeable  from  the  action  of  light  alone  on  sensitive  spots 
without  pressure.     Bang  and  Lesser  (ibid.)   have  observed  the  same. 


PHOTOTHERAPY  503 

healing  in  cases  of  lupus  of  the  skin  under  the   influence  of 
light  treatment,  and  arrived  at  the  following  conclusions^)  : 

Pieces  of  skin  removed  for  examination  24  hours 
after  irradiation  showed  the  vessels  dilated  and  the  sur- 
rounding parts  infiltrated  with  migrating  leucocytes. 
Besides  this,  it  was  seen  that  the  interstices  of  the  con- 
nective tissue  were  somewhat  wider,  and  that  there 
was  slight  vacuolisation  degeneration  which  was  clearly 
marked  in  the  giant-cells. 

In  pieces  removed  after  48  hours  the  same  phe- 
nomena   were    much    more    marked,    and    there    was, 


Fig.  105. — Giant-cell  from  a  case  of  lupus  two  days  after  Finscn  treatment. 
{Gleboivsky-Scrapin,  die  Veranderungen  im  Lupusgranulom  unter  der 
Einwirkung  des  concentrirten  Bogenlichtes  nach  der  Finscn  schcn 
Methode.  Verhandl.  d.  D.  dermat.  Gesell.  VII  Congr.  p,  pyknosis ; 
V,  vacuolised  nuclei;  k,   fat.) 

further,  fatty  degeneration  of  the  protoplasm  and 
necrobiotic  changes  in  the  nuclei  of  the  granuloma-cells, 
especially  in  the  giant-cells  (pyknosis  and  chromato- 
lysis,  Fig.  105).  After  repeated  sittings  these  destruc- 
tive appearances  in  the  giant-cells  increased,  and  iinally 
the  cells  disappeared  entirely.  This  happened  on  an 
average  after  4  to  ;  irradiations.  The  processes  of 
degeneration  in  the  epithelioid  elements  were  much  less 
marked  as  compared  \\\t\\  those  in  the  other  graiuiloiiKi 


')  C.  Scrapin,  Ucl)er  die  Voriinderungcn  im  T,upns  prantildiu  nntcr  dor 
Einwirkung  des  concentrirten  Bogenlichtes,  etc.  VII  Congr.  d.  deutsch.  der- 
matolog.   Gesellsch.   Verhandlimgsbericht,  p.  500  ff. 


504  RADIO-THERAPY 

'  elements  {a  point  of  difference  from  the  changes  in  the 
lupus  growth  after  treatment  with  the  Roentgen-rays, 
when  such  varieties  of  effect  have  not  been  observed, 
(cf.  p.  287  ff)  ;  but  Glebowsky  and  Serapin  noticed  in 
them  changes  of  a  purely  progressive  character,  e.  g., 
elongations  of  the  nuclei  and  the  cell-bodies  and  elements 
of  a  spindle  shape  were  met  with,  which  seemed  at 
times  to  pass  into  fibres.  The  lymphoid  elements  of 
the  lupus,  too,  showed  during  the  acute  reaction  rather 
pronounced  fatty  degeneration,  and  later  on  oval  and 
spindle-shaped  cells  were  observed  amongst  them.  As 
the  process  of  reaction  advanced  and  died  away  the 
cell  elements  in  the  granuloma  disappeared  more  and 
more,  beginning  with  the  upper  layers  of  the  corium, 
and  the  connective  tissue  became  more  and  more  con- 
spicuous (Fig.  106).  Only  at  the  end  of  the  treatment 
were  the  numerous  blood  vessels  contained  in  the  granu- 
loma quite  obliterated. 

According  to  A.  Sack's  investigations  on  lupus,  ulcus 
rodens,  and  naevus  vasculosus  planus  ^)  the  blood-vessels 
are  the  first  point  affected  by  the  light.     The  endothe- 
lium lining  their  walls  swells  and  grows  rapidly  and 
endarteritis  results,  with  final  obliteration  of  the  vessels. 
The  retrogressive  changes  in  the  character  of  the  cells 
which  show  themselves,    and  are  in  part  of  a   necro- 
biotic  nature,  are  purely  elective,  attacking  only  certain 
less  persistent  elements  of  the  disease  tissue,  whilst  the 
other   elements   both   within    and   without   the   morbid 
growth  are  stimulated  to  activity. 
Since  at  each  sitting  only  one  small  spot  can  be  treated, 
and  as  this  has  to  be  treated  again  more  than  once,  the  whole 
process  of  cure  cannot  but  be  of  long  duration;  precisely  how 
long  depends  on  the  intensity  and  extent  of  the  disease.     Small 
isolated  lesions  can  be  cured  in  a  few  sittings,  but  large  growths 
may  need  to  be  treated  for  a  year  or  more,  and  tax  severely 
the  patience  of  both  doctor  and  patient.     In  order  to  shorten 


^)  Miinchen.  med.  Wochenschr.,  July  8.    1902. 


PHOTOTHERAPY 


505 


the  period  of  treatment,  very  extensively  affected  parts  which  are 
much  infiltrated  and  darkly  pigmented  are  first  treated  with 
pyrogallol  ointment,  and  especially  deep-seated  nodules  may  be 
destroyed  by  the  cautery. 

In  the  light  treatment  of  lupus  vulgaris,  just  as  in  the  X-ray 
treatment,  it  is  well  to  make  a  break  with  the  treatment  after 
a  powerful  reaction,  so  that  it  may  be  seen,  when  the  acute 


A 


*0    "«* 


r  a 


Fig.  106. — A  Lupus  nodule  after  four  sittings.  (From  Glcboivsky-Scrapin 
1.  c.)  (a)  Blood  vessels  with  hyperplasia  of  the  endothelium,  (c)  Granu- 
lation elements  between  the  epithelioid  cells,     (f)  Connective  tissue. 

effects  have  died  away,  whether  it  is  advisable  to  continue  the 
treatment. 

According  to  Forchhammcr,^)  generally  after  some  lapse 
of  time,  when  the  reaction  has  died  away  and  the  whole  part 
is  again  in  a  normal  condition,  there  are  remains  of  the  disease 
left  in  the  shape  of  isolated  deep-seated  nodules.  It  is,  there- 
fore, necessary  to  watch  the  case  carefully  and  to  give,  where 
necessary,  short  supplementary  treatment  once  or  several  times, 
as  the  case  may  be. 

In  the  case  of  not  too  extensive  and  in\eterate  lupus  growths 


')   VII  Congress  d.  deutsch.   dermatol.  GcscIIsch..  Brcslau,   1901. 


5o6  RADIO-THERAPY 

of  not  more  than  lo  years'  standing  the  average  duration  of 
the  first  treatment  may  be  taken  as  3  to  4  months.  Cases  of 
greater  extent  and  longer  standing  are  likely  to  require  longer 
treatment,  and  complete  cure  is  in  such  cases  more  uncertain, 
in  great  measure  on  account  of  the  changes  brought  about  in 
the  lupus  tissues  in  the  course  of  the  disease,  and  by  the  treat- 
ment previously  tried  for  it.  These  changes  are  of  the  nature 
of  fibrous  scar-tissue,  intense  brown  pigmentation,  and  consid- 
erable infiltration  (Forchhammer) ,  and  they  all  render  it  more 
diflScult  for  the  light  to  penetrate  the  tissues. 

Both  Finsen  and  his  fellow-workers  lay  special  stress  on  the 
importance  of  keeping  the  patients  under  observation  for  a  long 
time'  after  treatment. 

Although  the  method  gives  the  most  favourable  results 
(according  to  Forchhammer,  85%  of  cures),  there  is  yet  a 
small  number  of  cases  (2  to  3%)  in  which  it  fails.  Then 
there  are  the  cases  in  which  the  disease  attacks  the  mucous 
membrane,  but  even  when  it  is  localised  at  the  body  orifices, 
the  gums,  the  palate  or  the  tongue,  it  may  be  treated  by  this 
method  {Lebon,^)  Torok  3.nd  Schein  ^)) .  With  a  considerable 
number  of  patients  there  are  relapses.  Forchhammer  reports 
that  this  is  especially  the  case  with  patients  who  neglect  to 
come  up  for  inspection  after  the  end  of  the  treatment,  or  with 
cases  where  there  is  extensive  inflammation  of  the  mucous  mem- 
brane, or,  finally,  with  patients  who  are  attacked  very  soon  after 
treatment  by  severe  and  debilitating  disease,  e.  g.,  erysipelas 
or  influenza. 

Brocq^)  mentions  one  case  in  which  irradiation  produced 
always  the  most  violent  eczema  and  cedema,  so  that  it  could  not 
be  adopted. 

According  to  A/.  Morris  and  E.  Dore*)  cases  of  lupus  are 
unsuited  to  the  Finsen  treatment,  which  are  accompanied  by 
much  scarring  and  pigmentation  and  great  vascularisation  and 
thickening  of  the  skin,  and  those  which  occur  in  certain  regions 


')  La  Phototherapie,  Paris,  Societe  cl'editions  scientifiques.  1901. 

p  L.  c. 

')  IV  Intern.  Congr.  de  Dermatologie.  Paris,  1900. 

*)  Brit.  Med.  Journ.,  Feb.  9,  1901. 


PHOTOTHERAPY  507 

(eyes,  mouth,  nostrils).  Lcrcddc  and  Pautkr  recommend  pre- 
paratory treatment  with  scarification  and  cauterisation  in  cases 
where  previous  remedial  eftorts  have  produced  sclerosis  ^ ) . 

There  are  a  few  drawbacks  to  set  against  the  advantages 
of  this  method,  its  efficacy,  its  elective  action  on  lupus  whilst 
preserving  all  sound  tissue,  its  painlessness,  its  excellent  cos- 
metic results,  its  freedom  from  unpleasant  and  unexpected 
after-effects.  The  method  demands  a  large  plant,  which  is  costly 
both  to  buy  and  to  maintain  in  operation  (on  account  of  the 
powerful  current  required)  ;  it  necessitates  a  trained  staff  of 
attendants,  and  by  its  tedious  course  it  makes  great  demands 
on  the  patience  of  both  doctor  and  patient,  and  requires 
from  both  considerable  powers  of  physical  endurance.  Com- 
parisons have  been  drawn  between  the  light  treatment  and  the 
Roentgen-ray  treatment,  and  the  latter  method  has  been  termed 
the  more  simple,  quick  and  cheap.  Many  {Kiimmel  and 
others)  have,  therefore,  recommended  that  isolated  lupus 
patches  should  be  treated  by  the  F'msen  method,  and  larger 
areas  of  disease  with  the  Roentgen-rays.  Objectively  consid- 
ered, the  Roentgen  treatment  is  certainly  simpler;  the  tube 
needs  only  to  be  directed  rightly  on  the  patient,  and,  provided 
he  remain  still,  he  can  be  then  left  to  himself  and  there  is  no 
need  of  specially  trained  attendants.  The  duration  of  the  single 
sittings  is  much  shorter  than  with  the  Finsen  treatment,  and  the 
Roentgen-ray  treatment  is  just  as  painless;  the  area  which  it  is 
possible  to  treat  each  time  with  the  X-rays  is  much  larger  than 
with  the  Finsen  treatment,  and  the  appearance  after  treatment 
is  quite  as  good.  But  on  the  other  hand  we  must  consider  that 
even  though  the  Roentgen  treatment  does  not  require  so  efficient 
a  staff  of  attendants  it  presupposes  in  the  operator  great  experi- 
ence and  practice,  and  demands  from  him,  not  indeed  the  same 
physical  endurance,  but  the  capacity  of  judging  correctly  and 
measuring  the  intensity  of  irradiation,  the  suitable  time  of 
exposure,  etc.,  whilst  with  the  Finsen  method  no  such  niceties 
ha\X'  to  be  taken  into  account. 

Further,  in  many  cases,  from  the  Roentgen  treatment  there 


')   Soc.  (Ic  Dcrmatolog.,  Ai)ril   r,   if/52. 


5o8  RADIO-THERAPY 

can  only  be  assurance  of  definite  results  if  violent  and  painful 
dermatitis,  persisting  to  the  end  of  the  cure,  be  accepted  as  part 
of  the  process;  and  its  results  are  by  no  means  always  so  evi- 
dent as  with  the  rival  method. 

There  is  probably  not  much  difference  between  the  two 
methods  as  regards  either  their  value  in  lupus  of  the  mucous 
membrane  or  the  total  length  of  time  required  for  a  cure.  With 
each  method  the  main  treatment  needs  to  be  followed  by  sev- 
eral periods  of  supplementary  treatment.  We  may  say  indeed 
that  the  advantages  of  the  physical  treatment  of  lupus  are  not 
to  be  sought  in  any  shortening  of  the  time  of  treatment  (which 
is  generally  not  less  than  that  required  by  any  of  the  previous 
methods),  but  in  the  fact  that  they  are  conservative  and  almost 
painless  and  give  excellent  cosmetic  results. 

These  considerations  point  to  the  X-ray  treatment  as  being 
suitable  in  cases  where,  for  reasons  not  connected  with  the  dis- 
ease itself,  the  light  treatment  cannot  be  used,  and  on  the  other 
hand  a  suitable  Roentgen  apparatus  is  available. 

Finsen's  method  and  its  results  have  received  recognition 
on  all  hands.  Numbers  of  medical  men  have  travelled  to 
Copenhagen  to  see  and  study  the  light  treatment  on  the  spot. 
The  present  writer  is  one  of  those  who  have  had  an  opportunity 
of  inspecting  the  arrangements  of  the  Finsen  Institute,  and  he 
can  only  express  admiration  of  the  excellent  way  the  v>'hole  thing 
is  planned,  the  high  scientific  attainments  of  the  heads  of  depart- 
ments {Bang,  Forchhammer,  Ryn  [L^/r^^w],  B'le)  and  the  zeal 
and  enthusiasm  with  which  they  work  to  further  the  good 
cause. 

Finsen's  statements  have  already  been  amply  confirmed  by 
the  most  eminent  authorities.  Fassar,  Lesser,  Jadassohn, 
Sabouraiid,  Petersen,  Malcolm  Morris,  Leredde  and  Pautier, 
Ehlers,  Biirgsdorf,  Mackenzie,  Dore,  Seqiieira  and  many  others 
report  similar  experiences. 

Treatment  with  concentrated  sunlight  is  carried  out  in  just 
the  same  way  as  with  the  arc-light  apparatus;  only  care  has. 
to  be  taken  to  keep  the  stand  of  the  concentrating  lens  con- 
stantly in  a  right  position  with  regard  to  the  sun. 

As  has  already  been  mentioned,  various  simplifications  of 


PHOTOTHERAPY  509 

the  Finsen  apparatus  have  been  designed  {Foveau-Troiive, 
Lortet  and  Geuoiid),  and  quite  satisfactory  results  are  said  to 
have  been  attained  with  short  exposures  (i^  to  30  minutes: 
Gaston,  Baiidou'ni,  Cluitin,  Fovcau  dc  Counnclles,^) 
Dit    Caste!,-)     Lehoii,-)     Gaston,    Baiidoiiin    and    C/iatin  ■^)) . 

The  new  iron  electrode  lamps  do  not  seem  to  be  so  suit- 
able as  the  Finsen  apparatus  for  the  treatment  of  lupus  vulgaris. 

5.  Bang*)  himself  writes  that  "the  Finsen  apparatus  have 
maintained  their  supremacy  unrivalled  in  the  treatment  of 
deep-seated  affections  such  as  lupus  vulgaris;  for  these  we 
should  advise  against  the  iron  light."  Strebel,  too,  says  '")  :  "As 
the  light  from  the  electric  spark  and  from  the  iron  electrode 
lamp  can  only  act  on  the  superficial  skin  because  of  its  prepon- 
derance of  ultra-violet,  which  is  absorbed  in  the  epidermis  to 
a  great  extent,  the  earlier  Finsen  method  still  maintains  its 
position;  the  deap-seated  lupus  nodules  must  be  treated  with 
light  rich  in  colour  rays,  which  alone  can  penetrate  deeply." 

Bang  would  have  his  apparatus  used  in  cases  where  with 
simple  and  cheap  means  a  powerful  reaction  of  the  skin  and  a 
superficial  bactericidal  action  is  required.  Kromayer,  Liese, 
Below,  Kattenbracker  and  Schif  claim  to  have  had  good  results 
with  the  Kjeldsen  lamp  in  cases  of  lupus  vulgaris  and  erythema- 
tosus, alopecia  areata,  acne  rosacea,  eczema,  syphilitic  ulcers, 
condylomata,  faevus,  and  ulcerating  haemorrhoids. 

Alopecia  Areata. 
Since  this  affection  is  believed  by  many  dermatologists  to  be 
of  a  parasitic  nature,  and  since  light  kills  bacteria  and  stimulates 
the  growth  of  hair  whilst  producing  local  infiammation  of  the 
skin,'')  O.  Jersild')  suggested  the  application  of  the  light  treat- 
ment to  alopecia  areata. 


')  Le  medicin,   igo2,  Nr.  7,  Bruxclles. 

=)  L.  c. 

*)   Soc.  de  dermatolngic.  Ap.    i.   1902. 

*)   Deutsche  med.  Wochcnsclir.,  1902,  No.  2. 

")  L.  c,  p.  62. 

°)  The  method.s  of  treatment  usually  tried  aim  also  at  producing  hyper- 
aemia  by  means  of  chemical,  mechanical  (Jacqitct),  and  electric  irritants 
(Elir))uiini,  Bordicr). 

')   Annales  dc  derniatrjlogic,   1899,  p.  20. 


5IO  RADIO-THERAPY 

His  method  is  much  the  same  as  that  indicated  by  Finsen 
for  cases  of  lupus  vulgaris. 

The  concentrated  light  used  is  from  very  powerful  light 
sources.  The  hair  is  cut  oft  round  the  patches  in  a  zone  of  one 
to  two  centimetres. 

The  illumination  starts  at  the  periphery  in  the  healthy  part 
and  advances  gradually  towards  the  centre.  One  or  two  sittings 
of  an  hour  and  a  quarter  are  given  each  day.  Jersild  thinks 
it  is  not  necessary  to  use  a  compressor  on  the  morbid  spots;  the 
skin  is  cooled  down  now  and  again  by  moistening  with  cold 
water.     If  carried  out  rightly  the  treatment  is  painless. 

Each  diseased  spot  is  irradiated  only  once.  The  duration 
of  the  treatment  depends  naturally  on  the  extent  to  which  the 
disease  has  spread. 

The  immediate  result  of  the  treatment  is  to  stop  at  once 
the  further  falling  off  of  the  hair  at  the  spots  treated 
{Spiegler,^)    Jersild-)  ). 

After  a  longer  or  shorter  time  (at  the  earhest  after  eleven 
days — Jersild)  lanugo  appears  on  the  bald  patches,  and  this 
gradually  becomes  pigmented  and  thicker. 

The  more  recent  the  origin  of  the  disease,  the  better  are  the 
prospects  of  cure;  this  method  of  treatment  is  of  no  use  in 
cases  of  universal  alopecia  areata  of  many  years'  standing. 

The  results,  as  reported  by  Jersild,  are  very  encouraging. 

According  to  Forchhammer's  statistics,  30  cases  out  of  49 
were  cured  in  Finsen's  Institute.  Sabotiraiid's  experience  was  less 
happy-').  He  reports  that  no  specially  good  results  were 
attained  in  active  cases  of  alopecia  areata  by  this  method,  but 
that  it  was  successful  with  more  chronic  cases,  limited  in  extent. 
Sabotiraiid,  too,  attributes  the  effect  of  the  light  treatment  in 
alopecia  to  the  local  congestion  it  produces^). 


')  VII  Congr.  d.  deutschen  dermatol.  Gesellsch.,  Breslau,  p.  469. 

^)   Mittheilungen  aus  Finsen's  med.  Lichtinstit.,  I,  p.   113. 

■")  In  a  letter  kindly  sent  to  the  author  recently,  the  distinguished  French 
investigator  writes:  "J'ai  experimente  pendant  six  mois  la  phototherapic  de 
Finsen  dans  la  pelade.  Et  j'ai  obtenu  des  resultats  mediocres,  beaucoup  plus 
mediocres  que  I'Ecole  de  Copenhague  me  semblait  les  annoncer  dans  le  trait- 
ment  de  cette  maladie." 

*)   Quoted  by  H.  Lehon,  La  Phototherapie,   Paris,   1901,  p.  22, 


PHOTOTHERAPY  511 

Lupus  Erythematosus. 

Finscn,  Bang,  Forchliammcr,^)  Lcrcddi\-)  Petersen,'^) 
Saboiiraud,*)  G.  J.  Milller'")  and  others  have  tried  treating 
this  affection  with  the  concentrated  arc-Hght.  It  acts  quite 
satisfactorily  in  fresh  cases,  but  with  cases  of  longer  standing, 
and  especially  if  the  lupus  erythematosus  is  generalised,  it 
often  has  no  effect.  Still,  according  to  Lercdde,  there  have 
been  cases  which  could  not  be  effectively  treated  by  other 
methods  where  the  light  treatment  has  brought  about  distinct 
improvement.  Leredde  strongly  recommends  treating  the 
plaques  beforehand  with  high-frequency  currents.  Sahouraud 
combines  the  li^ht  treatment  with  scarification  and  galvano- 
puncture. 

/.  M.  H.  Macleod  '')  treated  5  cases  of  lupus  erythema- 
tosus by  the  Fiusen  method;  two  were  decidedly  improved,  two 
showed  no  change,  and  one  showed  obvious  change  for  the 
worse. 

Epithelioma. 

Fiusen,  Petersen,  Burgesdorf  and  others  have  seen  distinct 
improvement  from  the  light  treatment  with  superficial  epithe- 
liomata  in  the  early  stages.  Sequeira  prefers  treatment  with 
the  Roentgen-rays  for  this  disease. 

Nwvus    vascularis . 

According  to  Forchhamvier,  the  light  treatment  reduces 
materially  the  deep  red  colour  of  this  disease,  and  in  some  cases 
the  affection  was  entirely  cured.  Petersen  observed  with  one 
case,  in  which  the  nasvus  extended  from  the  forehead  to  the 
eyelid,  that  there  was  improv^ement  not  only  in  the  part  of  the 


')  Congres  pour  I'etude   de  la   tubcrculose,    Paris,    1898,   and   Dcrmatol- 
og.  Congress,  Breslau.  1901. 

^)  Bulletin  general  de  therapeutiquc. 

')  VII  Congr.  d.  dcutschcn  dcrmatnlog.  Gescllsch.,  iQOi. 

*)  L.  c. 

»)  L.  c. 

*)  Brit.  Med.  Assoc,  meeting  at  Manchester,  July  30,  iy02. 


512  RADIO-THERAPY 

forehead  treated,   but  also  in  the  part  of  the  nasvus  on  the 
upper  hd,  which  of  course  could  not  be  irradiated. 

Other  Skin  Diseases. 

Treatment  with  intense  hght  irradiation  has  been  tried  with 
a  variety  of  other  skin  diseases  (acne  vulgaris,  Finsen;  furuncu- 
losis,  Strebel,  Barbensi;  acne  rosacea,  Finsen,  Strebel;  rhi- 
nophyma,  Leredde;  psoriasis,  G.  J .  Midler,  Strebel,  Barbensi; 
sycosis  parasitaria  and  non-parasitaria,  Finsen,  G.  J .  Miiller; 
biskra-button,  Petersen;  favus,  Finsen)  ;  the  experience  gained 
is  still  limited,  the  results  varying  and  uncertain.  Varicose 
ulcers,  too,  septic  wounds,  fistulas  after  operation  on  bubo,  etc., 
are  said  by  G.  J.  Miiller  and  others  to  heal  more  quickly  under 
light-treatment. 

Finsen  ^)  recommends  also  concentrated  light- 
treatment  for  bacterial  affections  which  are  not  quite 
superficial,  and  where  there  is  the  possibility  of  ren- 
dering the  tissues  partially  or  entirely  anaemic.  Such, 
e.  g.,  would  be  the  case  with  tuberculous  affections  of 
the  smaller  joints  and  the  extremities  in  the  case  of 
small  children;  here  the  tissues  are  very  transparent,  and 
might  readily  have  the  blood  expelled  with  an  Esmarch 
bandage.  G.  Hiirtado  claims  to  have  cured  arthritis 
tuberculosa  in  the  elbow-joints  by  this  means  "). 

The  author  is  not  aware  if  there  are  any  further 
experiences  of  the  kind. 

It  has  been  already  mentioned  (cf.  p.  321)  that 
sun-baths  have,  under  certain  conditions,  proved  effica- 
cious with  such  complaints. 

Venereal  Diseases. 
G.    Barbensi    and    Strebel")     treated    primary    syphihtic 


^)  Ueber  d.  Anwendung  von  cone.  chem.  Lichtstrahlen,  Leipzig,  1899. 
p.    50. 

^)   Revista  Ibero-Americ.  de  C.  Med.,  1901,  No.  12. 

^)  Revista  critica  di  Clinica  Medic,  quoted  in  Fovcau  de  Courmdlcs, 
L'annee  electr.,  1902,  p.  392. 


PHOTOTHERAPY  513 

chancre,  gummata,  and  soft  chancre  with  concentrated  light 
and  irradiation  with  ultra-violet  rays  (from  iron  electrodes  or 
spark-light)  ;  the  local  specific  lesion  in  the  case  of  primary 
chancre  is  said  to  heal  quickly  under  this  treatment,  but  secon- 
daiy  eruptions  are  not  thereby  prevented.  The  light-treatment 
would,  therefore,  have  to  be  combined  with  mercurial  treatment, 
or  iodide  treatment  in  the  later  stages.  According  to  Strebel, 
with  venereal  ulcers  two  or  three  Irradiations  suffice  to  heal 
the  sore  within  a  few  days.  There  Is  no  evidence  of  distinct 
influence  on  glandular  swellings. 

The  Therapeutic  Use  of  Other  Sources  of  Light. 

§  68.  In  the  method  treated  of  In  the  foregoing  chapter  the 
voltaic  arc  is  the  source  of  the  light  used  for  Irradiation.  In 
Strebel's  method  the  light  of  the  condensed  spark  from  an 
induced  current  of  high  tension  Is  used.  It  has  long  been  known 
that  this  light  is  very  rich  In  ultra-violet  rays,  and  experts  In 
photography  and  spectrography  have  for  many  years  made  use 
In  their  spectroscopic  and  photo-spectrographic  experiments  of 
the  induction  spark  between  suitable  metal  alloys,  strengthened 
by  Ley  den   jars^). 

In  view  of  experiments  In  other  quarters  which  had  estab- 
lished the  fact  that  ultra-violet  rays  have  a  powerful  bactericidal 
effect,  it  was  to  be  presumed  that  light  Irradiation  from  the 
Induction  spark  would  have  a  specially  powerful  effect  in  this 
direction.  Marshall  JFard'-)  and  Strebel^)  have  furnished 
the  practical  proof  of  this.  Strebel  showed  that  the  spark  of 
an  Induction  coil  at  a  sparking-dlstance  of  20  cm.  kills  all  kinds 
of  microbes  at  70  to  140  cm.  distance  in  a  few  minutes,  and, 
if  the  objects  are  brought  to  the  source  of  light,  within  a  space 


')  Rood  (Fortschr.  der  Physik.  1864,  p.  257),  Bcrihclot  (Ann.  Chim. 
Phys.  (7)  19,  p.  150),  Tommasi  (Beibl.  Anna).  Phys.  Chem.,  1886.  p.  427). 
E.  H.  Cooks  (Phiios.  Mag.,  1899,  Ser.  5,  Vol.  XXXVII,  p.  40),  and  others 
have  shown  that  the  silent,  dark  electric  effluvia  of  influence  machines  and 
Ruhmkorflf  induction  coils  also  contain  many  ultra-violet  rays,  and  have  the 
same  actinic  action  on  photographic  preparations  as  light  rays. 

^)   Proc.  of  the  Roy.  Soc.  of  T.ondon.  1894.  Vol.  LTV,  p.  472  fF. 

')  Deutsche  med.  Wochenschr.,  1901,  Nos.  5,  6. 


514  RADIO-THERAPY 

of  time  which  compares  well  with  any  results  gained  with  the 
arc-light.  The  effect  on  the  skin  of  rays  from  the  induction 
spark  is  precisely  the  same  as  that  of  those  from  the  voltaic  arc; 
they,  too,  produce  erythema  and  pigmentation. 

The  biological  action  of  the  induction  light  is  in  large  part 
the  action  of  ultra-violet  rays.  Rays  of  greater  wave-length 
are  present  to  so  small  an  extent  that  any  possible  action  on 
their  part  would  be  quite  subordinate. 

Further  investigations  have  yet  to  determine  what  part  in 
the  known  and  still  unknown  action  of  this  irradiation  is  played 
by  the  "electric  waves"  originating  in  the  spark. 

One  reason  in  favour  of  using  spark-light  is  that  with  it, 
as  with  metal  electrode  arc-lamps,  the  source  of  light  can  be 
brought  quite  close  to  the  object,  and  the  effect  of  the  light 
thus  increased.  Bearing  this  in  mind,  and  also  the  circumstance 
that  the  light  source  proper  does  not  require  such  careful  guard- 
ing and  regulating  as  the  apparatus  before  mentioned,  and  that 
it  can  be  packed  in  small  compass,  the  Strehel  spark-light  appa- 
ratus would  seem  to  be  specially  suitable  for  use  in  cases  where 
it  is  desired  to  bring  the  action  of  the  ultra-violet  rays  to  bear 
on  the  body  cavities. 

The  Strebel  instrument  for  producing  this  light  consists  of 
a  small  spark-induction  coil,  or  it  may  be  a  large  one,  but  in 
any  case  only  a  small  spark-gap  is  used.  A  Leyden  jar  (or  a 
battery  of  such  jars)  is  inserted  parallel  with  the  spark-gap, 
i.  e.,  one  pole  joined  to  the  inner,  the  other  to  the  outer,  foil. 

The  so-called  capsule  apparatus  for  irradiating  the  external 
skin  consists  of  a  short  ebony  tube,  6  cm.  broad,  which  is  closed 
on  one  side  by  a  quartz  lens,  on  the  other  by  a  concave  mirror 
of  magnalium  metal.  The  conducting  wires  pass  through  the 
wall  of  this  apparatus  and  terminate  in  one  or  more  pairs  of 
aluminium  electrodes,  which  stand  opposite  to  each  other,  a 
short  distance  apart,  in  front  of  the  concave  mirror  (Fig.  107). 

Gorl  ^ )  inserted  insulated  aluminium  balls  one  behind  the 
other  in  the  shape  of  an  "S"  between  the  electrodes.  The  spark 
flashes  from  ball  to  ball  along  the  "S." 


')    Munchen  med.  Wochenschr.,  1901,  No.  19. 


PHOTOTHERAPY 


515 


^ 


r 


B 


Jl 


'4- 


Air  is  forced  into  the  capsule  through  an  opening  by  means 
of  a  small  bellows,  and  this  both  prevents  the  electrodes  from 
becoming  heated  and  drives  out  the  ozone  and  metallic  vapour 
formed  by  the  spark  ^).  The  apparatus  serves  as  both  light 
source  and  compressor,  and  is  pressed  by  the  patient  himself 
against  the  part  of  skin  to  be  treated. 

For  the  irradiation  of  the  cavities  of  the  body  Strchel  con- 
structed similar  instruments,  shaped  to  fit  the  parts  to  be  treated, 
like  catheters,  etc.  The  instru- 
ments are  intended  on  insertion  to 
have  the  effect  of  causing  local 
anzemia  through  pressure  and  the 
stretching  of  the  mucous  mem- 
brane. 

The  idea  of  this  apparatus 
may  be  good,  but  the  way  in 
which  it  is  carriec'  out,  i.  e.,  by 
glass  tubes,  etc.,  into  which  insu- 
lated wires  pass,  makes  it  of  doubt- 
ful practical  value.  Glass  is  used 
as  material  for  the  apparatus, 
without  regard  to  the  fact  that 
glass  is  a  powerful  absorbent  of 
ultra-violet,  and  that,  therefore, 
very  few  of  the  ultra-violet  rays 
of  the  induction  spark  traverse  it. 

It  is  true  Strebel  directed  that  quartz  windows  should  be 
put  in  the  instruments  opposite  the  sparks,  but  so  far  as  we  are 
aware  this  is  never  done. 

With  glass  apparatus  of  this  kind,  it  would  only  be  after 
very  long  irradiation  that  any  biological  or  therapeutic  action 
whatever  could  be  expected. 

The  introduction  of  a  glass  catheter  into  the  human 
urethra  is  not  without  its  danger.  We  may  recall  that 
not  long  ago  a  case  was  mentioned  where  a  glass  sound 


Jj 


7C 

— -e — 

Fig.  107. — Strebel  Instrument. 


')  The  liglit  itself  is  cold. 


5i6  RADIO-THERAPY 

broken  off  In  the  urethra,  which  could  only  be  removed 
by  operation. 

Strebel  proposed  as  another  form  of  s^ark-light  the  rays 
given  out  by  the  opening  spark  of  a  IFagner  hammer  with  an 
induction  apparatus.  Strebel  showed  that  this  light,  when  the 
interrupting-spark  is  produced  by  aluminium  contacts,  is  very 
rich  in  colour  rays,  though  not  to  so  marked  an  extent  as  the 
voltaic  arc-light,  and  is  even  richer  than  the  latter  in  ultra-violet. 
Cooling  arrangements  have  to  be  provided,  as  this  light  is 
very  hot. 

Both  the  writer  ^)  and  Strebel  -)  have  pointed  to  the  possi- 
ble therapeutic  utilisation  of  the  ultra-violet  rays  in  the  electric 
brush-light.  Strebel  constructed  a  small  condenser,  which  pro- 
jects these  electrical  discharges  in  a  circular  plane.  S.  Leduc, 
too,  gave  directions  for  a  suitable  apparatus  ^).  His  condenser 
is  insulated  in  a  capsule  with  a  quartz  end,  and  can  be  used  as 
a  compressor.  Five  to  ten  of  such  apparatus  can  be  inserted 
in  one  current  and  several  patients  thus  treated  at  the  same 
time. 

Irradiation  for  a  quarter  of  an  hour  to  an  hour  each  time, 
every  one  to  three  days,  is  applied  with  this  apparatus,  accord- 
ing to  the  length  of  time  before  the  action  shows  itself. 
According  to  Strebel,  the  treatment  proceeds  rapidly  with  this 
capsule  apparatus,  as  a  patch  5  cm.  across  may  be  at  once 
irradiated. 

We  have  so  far  only  Strebel' s  report  of  results  from  this 
method.  He  claims  to  have  had  very  good  results:  Lupus 
vulgaris  (distinct  improvement  after  several  irradiations  o,f 
three-quarters  of  an  hour)  ;  venereal  ulcers  (healing  after  sev- 
eral irradiations  of  half  an  hour)  ;  obstinate  psoriasis  (8  sittings 
of  an  hour  and  a  half  each)  ;  a  plaque  of  herpes  tonsurans  as 
large  as  a  5  mark  piece  (21  irradiations  of  half  an  hour); 
sycosis  (12  sittings  of  25  to  30  minutes — simultaneous  epila- 
tion) ;  eczema  madldans   (two  sittings)  ;  ulcus  cruris   (healing 


^)  Die  physiolog.    Wirkungen  der   Polentl.    Sitzungsber.   d.  k.   Akad.   d. 
Wissensch.  in  Wien,  Math,  naturw.  Gasse,  Vol.  CIX,  Part  III,  1900,  p.  652. 
')  L.  c. 
*)  Quoted  in  L'annee  electrique,  1901,  p.  389. 


PHOTOTHERAPY  517 

after  9  to  20  sittings),  and  alopecia  areata  (8  sittings).  This 
treatment  is  said  to  have  been  markedly  successful  with  dis- 
eases of  the  mucous  membrane,  arresting  the  discharge  and 
causing  the  disease  to  disappear  (fluor  albus  blenorrh. — 
irradiation  for  20  minutes  every  fourth  day,  combined  with  salt 
water  douches;  chronic  metritis — 10  intrauterine  Irradiations; 
gonorrhoea,  in  the  male — 5  or  6  sittings  of  15  minutes  each; 
otorrhoea — 10  sittings  of  15  minutes;  venereal  warts — 3  sit- 
tings). 

Strebcl  himself  allows  that  this  treatment  may  possi- 
bly produce  violent  irritation  of  the  mucous  membrane 
(inflammatory  swelling,  pain  on  micturition,  etc.). 

Even  when  carried  out  for  a  very  long  time  the  treatment 
of  lupus  vulgaris  with  electric  brush-light  does  not  produce 
completely  satisfactory  results.  Of  this  the  author  has  con- 
vinced himself  with  his  own  electrode,  which  (cf.  plate  Fig.  7) 
gives  out  brush-light  very  freely.  He  could,  Indeed,  perceive 
distinct  improvement^)  with  lupus  ulcers,  and  a  visible  ten- 
dency to  skin  over;  but  constantly,  after  a  longer  or  shorter  time, 
there  was  a  relapse. 

With  the  forms  of  light-treatment  so  far  described  the 
sources  of  light  used  were  bodies  which  were  made  to  shine, 
i.  e.,  to  give  out  light  rays,  by  their  heat  energy  being  raised  to 
the  point  at  which  light  Irradiation  begins.  As  we  (p.  385) 
have  seen,  besides  this  there  are  other  kinds  of  light  develop- 
ment: luminescence,  which  are  produced  by  external  agency, 
Indeed,  but  with  no  corresponding  rise  in  temperature.  The 
literature  of  medicine  in  the  last  few  years  describes  various 
attempts  to  turn  this  kind  of  light  to  therapeutic  account.  We 
might  include  the  induction  spark  amongst  light  of  this  order. 

The  light  produced  by  electricity  in  the  rarefied  atmosphere 
of  Geisslcr  tubes  is,  in  spite  of  its  apparent  feebleness,  good 
actinically,  having  a  considerable  proportion  of  ultra-violet  rays, 
as  has  been  proved  by  the  researches  of  Norley,')  H.  JF.  Vo^i^el, 


')   Die   Verwendunpf   dcr   SpanminRSfleklricitrit,  etc.    Referat   f.   <1.    VI 11 

Congr.  d.  dcutschcn  dtrmatolog.  GcscIIscli.,  I'itHii,  kjoi.  Vcrhandlungsber., 
p.    71. 

';    Photograph.   Mitthcihuigen,   1871,  Vol.   VIII,  p.   102. 


5i8  RADIO-THERAPY 

Caprion,^)  and  others.  This  light  is  cold.  Strehel  availed 
himself  of  the  photo-chemical  property  of  glow  light  by  con- 
structing instruments  for  the  irradiation  of  the  cavities  of  the 
body,  in  which  helium  was  used  as  the  gaseous  medium.  He 
reports  the  light  from  this  apparatus  as  being  strongly  bacteri- 
cidal, penetrating  the  tissues  well.  He  uses  this  light  chiefly  for 
the  treatment  of  affections  of  the  mucous  membranes,  in  simi- 
lar manner  to  the  light  of  the  induction  spark. 

Certain  physiological  and  therapeutic  effects  have  been 
reported  of  another  group  of  luminous  phenomena:  fluorescence 
and  phosphorescence. 

By  fluorescence  we  understand  a  peculiar  self-luminosity  of 
certain  bodies  which  is  evoked  by  light  rays  and  lasts  only  as 
long  as  the  irradiation. 

Fluorescence  is  a  peculiar  effect  of  absorbed  light. 

Fluorescent  light  contains,  as  a  rule,  only  wave-lengths 
which  are  not  smaller  than  those  of  the  light  producing  it. 
When,  e.  g.,  we  examine  the  fluorescence  of  quinine  solutions 
we  see  that  the  action  which  produces  the  fluorescence  is  peculiar 
mainly  to  the  short-waved  light.  But  in  this  fluorescent  light 
there  are  also  kinds  of  light  of  greater  wave-length  than  that 
of  any  component  of  the  light  producing  the  fluorescence;  there 
are,  however,  none  of  shorter  wave-length.  The  law  that 
fluorescent  light  cannot  contain  light  of  less  wave-length  than 
the  exciting  light  does  not  apply  to  other  substances,  e.  g.,  eosin, 
fluorescin,  and  naphthaline  red. 

The  quality  of  producing  fluorescence  is,  as  we  have  seen, 
common  to  those  rays  which  have  the  most  marked  physiological 
effect  (the  ultra-violet.  Roentgen-  and  Becquerel-rays) .  This 
is  remarkable  for  the  reason  in  particular  that  these  rays, 
according  to  our  theories,  are  not  closely  related.  It  seems 
natural  to  look  for  the  common  source  of  the  physiological 
action  in  their  power  of  producing  fluorescence;  that  this  is  so 
seems  proven:  (i)  by  the  capacity  of  the  animal  tissues  for 
fluorescence,  proved  by  various  investigators,  and   (2)   by  the 


')   Photographed  Spectra,  London,  1877. 


PHOTOTHERAPY  519 

peculiar   biological   effect   of   fluorescent   light,    as    shown   by 
Tappeiner  and  Raab. 

H.  V.  Tappeiner^)  induced  O.  Raab  to  test  the  action  on 
infusoria  of  the  fluorescent  light  obtained  by  the  illumination 
of  phenylacridin.  Paramoecicum  caudatum  in  a  suspended  drop 
in  a  damp  chamber  was  the  subject  of  this  experiment.  It  was 
seen  that  paramcecia,  in  an  acridin  solution  ( i  in  20,000),  died 
in  sunlight  in  6  minutes,  in  difiused  daylight  in  about  60  min- 
utes; but  if  kept  in  the  dark  they  were  alive  after  6,000 
minutes  ( 100  hours) .  An  eosin  culture,  mixed  in  an  eosin  solu- 
tion ( I  in  800),  arranged  in  the  green  part  of  the  spectrum 
of  a  powerful  electric  arc-light,  broken  up  by  a  quartz  prism, 
showed  after  two  to  four  hours'  exposure  all  degrees  of  injury, 
even  to  death.  The  other  parts  of  the  spectrum  (which  induced 
the  fluorescence  of  eosin  but  little)  had  no  effect  on  the  culture. 
When  a  paramoecia  culture  in  an  acridin  solution  ( i  in  20,000) 
was  arranged  so  that  all  the  light  reaching  it  had  to  pass  through 
a  4  to  5  cm.  layer  of  a  concentrated  acridin  solution  ( i  in  500) 
the  light  no  longer  took  effect;  the  paramcecia  were  healthy  after 
a  week,  even  when  exposed  to  sunlight.  But  when  a  quinine  solu- 
tion w^as  taken  as  screen  the  light  acted  as  usual,  obviously 
because  now  the  screen  absorbed  only  the  inactive  ultra-violet 
rays,  and  not  the  violet  rays  which  produce  fluorescence  in 
acridin.  This  last  experiment  proves  at  the  same  time  that  it 
is  not  the  fluorescent  light  which  is  harmful,  but  the  process  of 
fluorescence  stimulation  itself,  v.  Tappeiner  sums  up  the  results 
of  his  experiments  as  follows:  Light  becomes  highly  injurious 
to  paramcecia  in  the  presence  of  acridin,  phenylacridin,  eosin, 
and  quinine,  in  solutions  in  which  these  substances  in  them- 
selves (in  the  dark)  are  hardly,  if  at  all,  poisonous.  This 
action  of  light  is  closely  connected  with  the  fluorescent  quality 
of  the  substances  named.  The  injurious  power,  however,  lies 
not  in  the  fluorescent  light  produced,  but  In  the  process  of  its 
production. 

O.  Raab  surmises  that  wc  have  here  a  conversion  of  the 


')   Miinchcner  mcd.   Wochcnschr..    iqoo.    No.    i,   p.    5,   and   Zcitsclirift   f. 
Biologic,  Vol.  XXXIX. 


520  RADIO-THERAPY 

energy  of  the  light  rays  into  chemical  energy,  analogous  to  that 
of  chlorophyll,  which  also  is  a  highly  fluorescent  body.  There 
is  only  this  difference,  that  this  conversion  is  the  cause  of  death 
to  the  paramoecia,  whereas  to  plants  it  is  the  condition  of  con- 
tinued life. 

V.  Tappeiner  holds  that  this  kind  of  light  action  comes  into 
play  with  those  animal  organs  and  fluids  (skin,  retina,  blood  and 
lymph  serum)  which  have  the  capacity  for  fluorescence.  He 
surmises,  too,  that  the  cause  of  the  skin  inflammation  noticed 
by  Wedding'^)  in  beasts  fed  on  buckwheat  lies  in  the  fact 
that  substances  get  into  the  body  which  are  capable  of 
fluorescence. 

A  species  of  luminosity  very  closely  allied  to  fluorescence  is 
phosphorescence  (according  to  Becquerel,  fluorescence  is  only 
phosphorescence  of  very  short  duration).  A  large  number  of 
bodies,  under  the  influence  of  powerful  illumination,  especially 
from  light  sources  which  emit  a  large  amount  of  ultra-violet 
rays,  radiate  a  soft  light  precisely  similar  to  that  of  fluorescence. 
In  phosphorescence,  however,  the  radiation  persists  for  an 
appreciable,  often  even  for  a  considerable,  time  after  the  illumi- 
nation has  ceased,  whilst  fluorescent  substances  shine  only  during 
its  continuance. 

A  considerable  number  of  natural  and  artificial  substances 
have  this  quality  of  phosphorescence  to  an  evident  extent : 
among  natural  phosphorescent  bodies  ("light-absorbers"  and 
"light-magnets"),  we  may  mention  diamonds,  calcareous  spar, 
and  chlorophane.  Artificial  phosphorescent  bodies  include  the 
sulphates  of  the  alkali  earths,  which  are  obtained  by  heating 
sulphur  with  limestone,  barytes,  or  strontium  salts.  Sulphide  of 
calcium,  which  has  a  violet  phosphorescence,  is  the  best  and 
most  brightly  phosphorescent  substance  known  up  to  now.  This 
substance  is  called  after  its  discoverer  ''Balmain's  luminous 
colour." 

The  colours  of  phosphorescent  light  arc  not  only  dependent 
on  the  chemical  composition  of  the  substances  which  emit,  but 
they  are  to  a  large  extent  dependent  on  their  physical  nature 

')  Cf.  p.  332. 


PHOTOTHERAPY  521 

and  their  temperature.  The  intensity  of  phosphorescent  light 
is  increased  by  heating.  Like  fluorescent  hght,  phosphorescent 
light  consists  of  rays  of  greater  wave-length  than  the  exciting 
light;  there  is  much  in  favour  of  the  assumption  that  in  phos- 
phorescent light  energy  is  given  off  which  has  been  taken  from 
the  absorbed  light  of  the  exciting  light  source.  We  have  as 
yet,  unfortunately,  no  well  thought  out  theory,  free  from  all 
objections,  as  to  the  process  of  transforming  the  light  move- 
ment of  the  exciting  light  into  that  of  the  phosphorescent  light 
{A.  Lampa) .  The  light  of  the  best  and  most  brightly  shining 
phosphorescent  substances  excited  by  daylight  is  comparatively 
weak;  according  to  Eder,^)  when  in  immediate  contact  with  a 
bromide  of  silver  gelatine  plate,  it  acts  about  as  powerfully  as 
the  light  of  one  normal  candle  at  50  cm.  distance.  Phosphor- 
escent light  has  always  a  far  weaker  effect  than  the  light  which 
excited  the  phosphorescence. 

Seebeck  and  Becquerel  discovered  the  remarkable  fact  that 
the  yellow  and  red  rays  counteract  the  action  of  the  violet  rays, 
extinguishing,  or  at  any  rate,  considerably  weakening,  the 
brightness  produced  by  them. 

Whilst  fluorescent  plates  are  used  to  render  visible 
the  ultra-violet  spectrum  (this  spectrum  producing  visi- 
ble fluorescent  rays  on  the  regions  whereon  it  falls), 
phosphorescent  plates  are  used,  according  to  Becquerel , 
to  make  ultra-red  visible.     If,  e.  g.,  one  brings  into  the 
dark  a  plate  covered  with  Balmain's  luminous  colour, 
which  has  been   exposed  to  daylight  and  is  therefore 
luminous,  the  luminosity  will  disappear  where  ultra-red 
rays  fall  and  a  negative  picture  of  the  spectrum  will 
be  given. 
It  is,  perhaps,  permissible  to  connect  this  remarkable  fact 
with  certain  eft'ects  of  the  red  end  of  the  spectrum  on  animal 
tissues;  all  the  more  since  it  is  proved  that  certain  tissues  are 
capable  of  fluorescence,  and  that  the  process  of  inducing  fluor- 
escence produces  changes  in  the  tissue. 

Rays  of  phosphorescent  light  give  in  general  a  continuous 


')  Ausfiihrl.  Handb.  d.  Photogr.,  I,  i,  p.  461. 


522  RADIO-THERAPY 

spectrum  extending  into  the  blue.  The  colour  of  the  radiated 
light  is  independent  of  the  colour  of  the  exciting  rays,  i.  e.,  a 
certain  luminous  substance  gives  off  always  the  same  light,  be 
the  exciting  light  blue  or  violet  or  white. 

The  duration  of  phosphorescence  after  illumination  varies 
with  different  bodies.  There  is  no  connection  between  the 
intensity  of  the  phosphorescent  light  and  the  duration  of  the 
luminosity. 

As  may  be  seen  from  the  tables  in  Eder's  "Recepte  und 
Tabellen  fiir  Photographie  und  Reproductionstechnik,"page  72; 
the  photographic  eifect  (brightness)  of  blue  phosphorescent 
sulphide  of  calcium  diminishes  rapidly  after  the  light  impression 
has  been  received.  If  v/e  take  the  brightness  immediately  after 
illumination  as  100,  after  18  seconds  it  will  be  56.5;  after 
45  seconds,  25.1;  after  i  minute  35  seconds,  14. i,  etc.  The 
luminous  power  of  phosphorescent  colours,  too,  lessens  quickly 
after  the  light  impression,  more  rapidly  in  the  first  few  seconds 
after  insolation  than  later. 

After  the  discovery  of  the  X-rays,  H . Becquerel,^)  ^nd  simul- 
taneously with  him  a  number  of  other  physicists,  expressed  the 
opinion  that  phosphorescent  bodies  under  suitable  experimental 
conditions  may  be  made  to  emit  dark  rays  capable  of  acting  on 
the  photographic  plate  after  passing  through  opaque  bodies, 
and,  in  consequence,  to  exercise  the  same  kind  of  action  as 
Roentgen-rays  ^) . 

This  induced  the  author  to  make  some  experiments  with  a 
view  to  testing  the  possible  biological  effect  of  phosphorescent 
light. 

Herr  Hofrath  Eder  placed  at  the  author's  disposal  for  this 
purpose  a  standard  light  plate.  This  consists  of  a  layer, 
enclosed  within  two  glass  plates,  of  the  so-called  Bahnain  lumi- 
nous colour,  i.  e.,  of  a  mixture  of  sulphur  compounds  of  calcium, 
barium  and  strontium,  which  emit  an  extraordinarily  powerful 
and  long-lasting  phosphorescent  light.  (The  duration  of  the 
brightness  is  only  relatively  long — cf.  above.) 


^)   Fourth  edition,  Knapp,  Halle,   i^ 
")   Compt.  rend.,  1896,  p.  420. 


PHOTOTHERAPY  523 

To  make  the  phosphorescent  plate  shine,  2^/2  cm.  of 
magnesium  ribbon  was  burned  and  the  Hame  moved  to 
and  fro  as  close  as  possible  to  the  surface  of  the  glass. 
The  plate  then  shone  out  with  a  very  beautiful  intense 
blue  light  in  a  slightly  darkened  room.  As  the  lumi- 
nosity of  the  phosphorescent  substance  lessens  rapidly, 
the  illumination  with  magnesium  light  had  to  be 
repeated  every  three  minutes.  A  longer  piece  of  magne- 
sium ribbon  was  not  burned,  as  the  brightness  gained 
by  23/2  cm.  could  not  be  increased. 

This  luminous  layer  was  brought  as  close  as  possible 
to  a  diffuse  culture  of  staphylococcus  pyogenes  aureus 
on  agar  in  a  Petri  dish,  a  very  shallow  dish  being  chosen 
for  the  experiment,  in  which  a  threefold  thick  nutritive 
medium  was  poured. 

A  sheet  of  non-transparent  paper,  in  which  a  cross 
had  been  cut  out,  was  inserted  between  the  culture  and 
the  phosphorescent  plate.  This  was  done  to  make  it 
possible  to  distinguish  between  the  growth  of  the  irra- 
diated and  the  non-irradiated  parts. 

For  three  hours  the  experiment  was  continued,  the 
phosphorescent  plate  being  illumined  every  three  min- 
utes with  a  piece  of  magnesium  ribbon  2_^  cm.  in 
length,  and  then  laid  again  on  the  open  dish.  During 
the  illumination  with  magnesium  light  the  culture  was, 
of  course,  put  away  in  a  dark  place,  so  as  to  be  kept 
unaffected  by  any  action  of  the  powerful  chemical  rays 
of  the  magnesium  light.  After  3  hours  the  culture  was 
placed  in  the  incubator. 

The  next  day  the  nutritive  medium  was  covered  with 
a  thickly  packed  even  growth,  which  showed  no  trace  of 
variety  of  development. 

The  experiment  was  repeated  in  the  same  way  for 
6  hours  but  gave  the  same  negative  result,  as  tlitl  also  a 
typhus  culture  with  like  treatment. 
Phosphorescent  li}i,ht,  therefore,  of  the  'uttensity  (ivnilable  for 
these  experiments,  has  no  influence  on  bncterial  i^roKlh. 

Quite  recently  C.  Roth  has  employed  the  light  radiated  by 


524  RADIO-THERAPY 

phosphorescent  bodies  in  various  affections  of  the  cavities  and 
passages  of  the  body,  and  has,  according  to  his  accounts,  obtained 
favourable  results  in  cases  of  chronic  nasal  catarrh.  Any  result 
of  this  kind  would  appear  from  the  above  described  experi- 
ments to  be  in  no  wise  due,  as  Roth  seems  inclined  to  believe 
(Zeitschr.  f.  angew.  Chemie),  to  a  deleterious  action  of  phos- 
phorescent light  on  bacteria. 

Looking  back  on  the  results  of  investigation  thus  far  in  the 
realm  of  phototherapy,  we  see  that,  thanks  to  the  work  of 
photo-chemists  and  physicists  and  thanks  to  the  initiative  of 
numerous  medical  men,  we  already  possess  considerable  knowl- 
edge of  the  peculiar  qualities  and  effects  of  light,  and  are  in  a 
position  to  turn  this  force  of  nature  to  practical  therapeutic 
account.  There  remain,  however,  many  great  gaps  in  our 
knowledge  which  cannot  be  filled  up  without  further  hard  work. 
Especially  does  it  seem  advisable  in  future,  side  by  side  with 
the  close  observation  of  all  the  circumstances  under  which  the 
more  carefully  studied  highly  refrangible  short-waved  rays 
come  into  action  {e.  g.,  besides  the  chemical  activity  also  the 
brightness  of  the  light,  the  quantitative  determination  of  the 
absorbed  rays,  etc.),  to  study  also  the  manner  in  which  the  less 
refrangible  long-waved  rays  act  {e.  g.,  those  that  penetrate  more 
deeply  into  the  tissues),  as  well  as  the  way  in  which  various 
tissues  and  organs  react  to  illumination  with  rays  from  this 
region  of  the  spectrum. 


APPENDIX  TO  THE  TREATMENT  BY  X-RAYS 

In  the  endeavour  to  place  the  "dosage"  of  this  treatment  on 
a  more  exact  basis,  several  writers  have  suggested  auxiliary 
apparatus  for  denoting  the  amount  of  the  radiant  energy 
employed  (the  intensity  of  the  X-rays).  As  has  been  pointed 
out  (p.  245),  Beclere,  Gastou,  Oudin  and  others  recommend 
the  spititet?ieter  and  radiochromometer.  We  have  observed  that 
neither  of  these  instruments  appears  to  be  quite  adequate,  in  the 
case  of  the  spintemeter  for  the  following  reasons:  The  spinte- 
meter  is  designed  to  give  the  spark  equivalent  to  the  degree  of 
hardness  of  the  tube.  But  no  account  is  taken  of  the  fact  that 
various  induction  coils  produce  varying  electric  energies,  which 
come  into  action  in  equal-sized  sparking-distances.  Conse- 
quently a  Roentgen-tube  of  a  certain  vacuum,  inserted  in  the 
equally  large  spark-gaps  of  induction  coils  of  different  con- 
struction will  give  rise  to  varying  phenomena.  If,  e.  g.,  we 
insert  a  vacuum  tube,  which  in  a  voltolnn  coil  of  25  cm.  spark- 
ing-range  corresponded  to  a  spark-gap  of  7>^  cm.  into  the 
spark-path  of  a  Dessauer  apparatus  (which,  as  is  well  known, 
gives  more  powerful  secondary  currents),  we  should  have  with 
the  Dessauer  apparatus  a  whole  sheaf  of  sparks  at  a  distance 
(8  cm.)  across  which,  with  the  first  apparatus,  no  spark  could 
flash.  The  data  given  of  the  spintemeter  hold  good,  there- 
fore, for  the  apparatus  of  the  experimenter  concerned  alone,  not 
necessarily  for  other  apparatus.  In  order  to  make  the  results 
of  the  individual  apparatus  available  for  all  it  would  be  neces- 
sary to  give  also  the  construction  of  the  apparatus,  and  thereby 
make  it  possible  to  calculate  the  given  s-alucs  in  terms  of  other 
apparatus  —  in  any  case  a  matter  of  some  difficulty. 

It  is  well  known  that  the  X-rays  produce  certain  colours  In 
many  substances  {V'lUard,  Holzknccht).  Holzknecht  deter- 
mines the  amount  of  X-rays  absorbed  by  a  certain  salt   (the 


526  APPENDIX 

composition  of  which  is  not  given)  by  comparing  the  colour 
resulting  in  this  body  from  irradiation  with  a  standard  scale  of 
shades.  From  the  intensity  of  the  colouring,  that  is,  from  the 
corresponding  number  in  the  scale  of  comparison  {H)  conclu- 
sions may  be  drawn,  according  to  Holzknecht,  as  to  the  amount 
of  X-rays  absorbed,  and,  therefore,  also  as  to  the  probable  physi- 
ological effect  of  the  same  amount  of  rays. 

In  using  the  chromo-rad'wrictcr,  the  apparatus  is  placed  on 
the  part  of  the  exposed  surface  of  skin  which  is  most  adjacent  to 
the  tube-focus.  The  tube  is  either  kept  working  at  one  sitting 
till  the  desired  darkening  effect  is  reached  (this  is  determined 
by  comparison  with  the  standard  scale),  or,  where  the  treat- 
ment is  to  be  extended  over  several  sittings,  the  apparatus  may 
be  packed  away  in  some  non-transparent  receptacle  until  the 
next  sitting.  If  the  sittings  occupy  more  than  5  days,  the  irra- 
diation may  be  pushed  a  little  beyond  the  regulation  "dose," 
since  the  skin  recovers  somewhat  between  the  sittings. 


INDEX 


Aberration,  378,  379. 

Absorption  of  light,  380. 

Absorption  of  ultra-violet   raj's.   388. 

Absorption-spectrum,  384. 

Accumulators,  2"]. 

Accumulators,  capacity  of,  29. 

Accumulators,  charging  of,  216. 

Accumulators,  discharging  of,  218. 

Accumulators,  power  of,  29. 

Acetylene-light.  475. 

Acne  pilaris,   267. 

Acne  vulgaris,  liT,  300. 

Acne  rosacea,  300. 

Actinic  rays,  293. 

Actinium,  351. 

Actinometer,  375. 

Adrenalin,  494. 

After   treatment,  235,  278. 

Aigrette,  115. 

Albedo.  y]2>- 

Alopecia  areata,  2y],  272,  509. 

Alopecia,  persistent,  299. 

Alopecia,  pityroides,   275. 

Alternating  currents,  48. 

Alternating  currents  of  high  frequency, 

88. 
Alternating  current  machines,  49. 
Ampere,  22,  2,'^. 
Amperemeter,  39. 
Ampere-hour,  2>^,  46. 
Amplitude,  51. 
Analgesia,  166. 
Anaesthesia,  104. 
Angle  of  incidence,  yjT. 
Angle  of  reflection,  yj"]. 
Angstrom's  unit,  383. 
Anode,   25,   188. 
Anode-rays,   191,  229. 
Anti-cathode,  202. 
Anti-cathode,  over-heating  of,  202. 
Arc-lights,  43. 
Arc-light  lamps,  479,  486. 
Arc-light  baths,  488. 
Armature,  50. 
Athcrmanous  bodies,  388. 
Augmenting  Index,  14. 
Aureola,   117. 
Auromin,  376. 
Auto-conduction,   100. 


B 
Bacteria,  influence  of  Becqucrel  rays  on, 

.^55- 

Bacteria,  effect  of  electricity  on,   140. 

Bacteria,   effect    of    high-frequency    cur- 
rents on.    126. 

Bacteria,  effect  of  light  on.  401. 

Bacteria,   effect  of  X-rays  on,   305,   312. 

Balmain's  luminous  paint,  520. 

Barium,  351. 

Battery,   electric.    15. 

Battery,  galvanic.  24. 

Battery  connection,  34. 

Battery  poles,  24. 

Biliary  calculi,   304. 

Bismuth,  351. 

Bipolar  treatment,  lOi. 

Blepharitis,   271. 

Bolometer,   387. 

Breaks.     See  Interrupters. 

Bremer  lamp.  487. 

Brush-discharge,   116. 

Brush,   faradic.    103. 

Butterfly  patch,  298. 

C 

Cathode,  25,  188. 

Cathode  rays,  159,  187.  231. 

Cathode  rays,  nature  of,  188. 

Callus,  effect  of  X-rays.  305. 

Calorescence,  385. 

Capacity,  7,  12. 

Capacity  of  accumulators,  29,  32. 

Carcinoma.  294.  302. 

Cascade-battery,  15. 

Channel  rays,  191. 

Charging,  electrical.  5. 

Chemical  action  of  light,  393. 

Chemical  action  of  X-rays.    194. 

Chemical    action   of   Bccciuerel-rays,   352. 

Chlorophyl,    influence  of  Becquercl-rays 

on,  3.S9- 
Chlorophyl-f unction.  396. 
Chondro   sarcoma,  303. 
Chromoradiometer.   525. 
Conunutator.  49. 
Compressors,  493. 

Concave-grating,  spectroscopic,  392. 
Concentrating    apparatus    for    arc-light, 

495- 


528 


INDEX 


Concentrating    apparatus    for    sunlight, 

508. 
Condensation,   100. 
Condenser,  12,  57. 
Conductors,  3,   19,  20. 
Constant-current  machines,  49. 
Corpuscles,  x,  390. 
Coulomb,    32. 
Coulomb's  law,  6. 
Crookes'  radiating  matter,  189. 
Cumulative  efifect  of  X-rays,  241. 
Current  closed,   32. 
Current  collector,  50. 
Current  interrupter,   64. 
Curve,  chemical,  388. 
Curve,  height  of,  388. 
Curve,  thermal,  388. 

D 

D'Arsonvalisation,   100. 

D'Arsonval's  apparatus,  93,  95. 

Dark  cathode   space,    188. 

Decade  resisting  principle,  508. 

Deflection,  391. 

Degeneration,     vacuolisation,     154,    342, 
503. 

Density,   electric,  6. 

Depigmentation,  241. 

Dermatitis  from  Becquerel-rays,  359. 

Dermatitis     from     high-frequency     cur- 
rents,  161. 

Dermatitis  from  X-rays,  22>7- 

Dermatitis    from    X-rays,   prognosis   of, 
347- 

Dermatitis   from    X-rays,    treatment   of, 
347- 

Dermatitis  papillaris  capillitii,  229,  22,7, 
270. 

Dermo  lamp,  486. 

Diabetes,  167. 
,,  Diathermanous   bodies,   388. 

Dieletric,   13. 

Dieletric,    constant,    13. 

Diffraction,  391. 

Dioptric,   378. 

Discharge   point,   6. 

Discharge,  caterpillar,  120. 

Discharge,  silent,   120,  513. 

Discharge,    oscillating,    16. 

Disconnector,   60. 

Dispersion  of  light,  281,  T,y7. 

Dispersion   of   light,   abnormal,   390. 

Distance,  influence  of,  235. 

Distance  effects,  xiii. 

Drossel-tubes,  215. 

Dynamos,   2>7- 

Dyne,  7. 


Eczema,  237,  295,  455. 
Electricity,   free,   12. 


Electricity,  bound,   12. 

Electricity,  negative,  3. 

Electricity,  positive,  3. 

Electricity,   friction,  3. 

Electricity,   static,    12. 

Electricity,  voltaic,   19. 

Electric  current,  8. 

Electric  current,  magnetic  effect  of,  45. 

Electric  equilibrium,    12. 

Electrical  oscillation,  87. 

Electric  spark,  13. 

Electric  meters,   46. 

Electric  vibrations,   physiological  effects 

of,   163. 
Electro-dynamometer,  40. 
Electrolysis,  25. 
Electrolyte,  25. 
Electro-magnet,  49. 
Electro  magnetic  theory  of  light,  87. 
Electro-motor,  52. 
Electro-motive  power,  9,  19,  22,  33. 
Electrode  for  monopolar  coil-discharges, 

149. 
Electrons,  xi,  26. 
Electrostatic  discharge,  1 16. 
Electroscope,  6. 
Electro-therapy,   162. 
Elements,  galvanic.  21,  24. 
Elephantiasis,  177,  237,  301. 
Energy,   electrical,   7. 
Epidermis,    absorption  of  light  by,   430. 
Epithelioma.  237,  391,  511. 
Erythema  or  Eczema  solare,  415. 
Erysipelas,   chromotherapy  in,  457. 
Erythema   from  X-Rays,  254. 
Etiolation,   396. 
Exposure,  influence    of    length    of,    235, 

245- 
Extra  current,  54. 

Eye,  effect  of  Becquerel-rays  on  the,  361. 
Eye,  effect  of  light  upon  the,  436. 
Eye,  effect  of  magnetic  field  on  the,  184, 

310. 
Eye,  effect  of  X-rays  on  the,  308. 


Faradic  brush,  103. 
Farad,   12. 

Faradisation,  99,   114,  275. 
Favus,  237,  263. 
Field,  electric.  8. 
Field,    magnetic,    7. 
Filtration  of  light,  384. 
Fissura  ani,   179. 
Fluorescence,  188,  385,  518. 
Fluorescent-screen,  202. 
Focus-tubes,  202. 
Folliculitis  barb£e,  266,  267. 
Foucault's  currents,  56. 
Foucault's  interrupter,  68, 
Focus  of  lenses,  379, 


INDEX 


529 


Franklinisation,  114,  162,  172. 
Franklin's  plate,    14.  90- 
Fraunhofer's  lines,  386. 
Furunculosis,  300. 


Galvanic  current,  21. 

Galvanic  current,  heat  and  light  effects 

of.  41. 
Galvanization,   163. 
Galvanism,  19. 
Galvanometer,  38. 
Geissler  tubes,  89. 
Generator,  52. 
Gramme's  ring,  50. 
Grating,  391. 
Growth  movement,  397. 

H 

Hair,  loosening  of,  by  X-rays,  253. 

Hair,  falling,  cause  of,  346. 

Heat  rays,  ix,  325,  387. 

Heliotropism,  398. 

Henoque's   method,   107. 

Hertzian  rays,  88. 

Hertzian  waves,  197. 

High-frequency  currents,  85. 

Hirschmann's     electrolytic     interrupter, 

77-  .      . 

Histological   investigations,   152. 
Hot  wire  instruments,  41. 
Hyperesthesia,   104. 
Hypertrichosis.  237.  276. 
Hyper-ultra-violet  rays,  x,  364. 
Hysteresis,  45. 


Impeding-resistance,  64. 

Impotence,  173. 

Incandescent  light,  42. 

Incandescent  light  baths,  466. 

Induced  current,  48. 

Induction,   47. 

Induction,  electro,  52. 

Induction,  electro-static,  12. 

Induction-spark,   microbicidal  action  of. 

513- 

Influence,  7. 

Ions,  26. 

lonisation,   196. 

Intensity,  chemical,   of   sunlight,  451. 

Intensity,  chemical,  of  artificial  light- 
sources.  464. 

Intensity,  chemical,  of  electric  current, 
22,  32. 

Intensity,  chemical,  of  X-rays,  determi- 
nation of,  240,  245,  247,  525. 

Intensity,  chemical,  of  X-rays,  influence 
of,  235,  24O. 


Interference  of  light,  391. 
Interruption,  influence  of  rate  of,  247. 
Interrupters,  57. 
Interrupters,  electrolytic,  59,  73.  75,  77y 

79.  80. 
Insulators.  4. 
Invisible  discharge.    117. 
Irritability  movement.  397. 
Iron  arc-lamp,  405.  485,  486,  509- 


Jar  residue,  15. 
Joule's  law,  41. 


K 


Katoptrik.  377. 

Keratitis,  light   treatment  of,  464. 

Kohl's  electrolytic  interrupter,  75. 


Latent  period  after  light-treatment,  417. 

Latent  period  after  X-ray  treatment,  312. 

Lead,   radio-active,  352. 

Lead  fuses,  41. 

Lenard  rays,  190. 

Lenses,  378. 

Lenz's  law,  56. 

Lepra,  237,  294. 

Levy's  interrupter,  70. 

Leyden-jars,  15. 

Lichen  ruber  planus,  298. 

Light  cathode  band,   188. 

Light-power  of  the  sun,  450. 

Light,  369. 

Light,  stimulating  action  of,  409,  415. 

Light,  destructive  action  of,  397- 

Light-filters,  407. 

Light  and  air-baths,  454. 

Light-sources,  470. 

Light-strength,  372. 

Light-rays,  2,72. 

Light,  electro-magnetic   theory  of.  370. 

Light,   emission  theory,  369. 

Light,   undulatory   theory.  369. 

Light,  deficction  of.  391. 

Light,   refraction  of,  378. 

Lines  of  force,  magnetic,  8. 

Luminescence,  517. 

Lupus  erythematosus,  177,  237,  298,  364. 

511- 
Lupus  vulgaris,  236,  240,  281,  364,  498. 

M  • 
Machines,  electrical.  17. 
Magnetic  field,    physiological    effect    of, 

120. 
Masks.  260. 

Magnetic  induction.  48,  53. 
Massage,  electrical,   177. 
Measles,  chromutheraiJV  in.  457. 


S30 


INDEX 


Measurement  of  electric  current,  38. 
Measurement,  technical,  32. 
Mechanical   concussion,    161. 
Mercury  interrupter,  66,  71. 
Metabolism,  intiuence  of  high-frequency 

currents   on.    106. 
Metabolism,  influence  of  light  on,  439. 
Metabolism,  influence  of  X-rays  on,  305. 
Meters,  46. 
Moist  chamber,  407. 
Monopolar  coil  discharge,  143. 
Monopolar  voltaic  current,   181. 
Morton's  currents,  85. 
Mucous  membranes,  174. 
Multiple-phase  currents,  51. 
Mycosis  fungoides,  237,  294. 

N 

Nsevus  flammeus,  237,  301.  364. 
Nsevus  pigmentosus  pilosus,  229. 
Nsevus  vascularis,   with  light-treatment, 

511- 
Nails,  changes  in,  after  X-rays,  340. 
Neef's  hammer,  65. 
Nervous  system,  influence  of  d'Arsonval- 

isation  on,  109. 
Nervous  system,  treatment  of,  172. 
Nerves,  influence  of  X-rays  on,  305. 
Neuralgia,   303. 
Normal  candle,  S73- 
Normal  candle  lamp,  373. 
Nutation,  398. 


O 


Obesity,   167. 
Ohm,  30,  34. 
Ohm's  law,  S3- 
Opening-spark,  57. 
Optical  axis,  377. 
Optogram,   437. 
Osmosis,  215. 
Osteoperiostitis,  305. 
Ozone,  325. 


Parallel   connection,  27- 

Peletier's  jars,  396. 

Pemphigus   foliaceus,   298. 

Penetrator,'  203. 

Period,  57. 

Peritonitis,  tubercular,  304. 

Permeating  electricity,  182. 

Phase,  51. 

Phosphorescence,  188,  385,  520. 

Photometer,  374. 

Phototaxis,  478. 

Pigment  changes  from  X-rays,  252. 

Pigmentation  after  light  treatment,  420. 

Pitchblcnd.  351. 

Plate,   collecting,    12. 


Plate,  condensing,  13. 

Plate  interrupter.  81. 

Platinum  interrupter,  79. 

Platinum,     deposit    on    Roentgen-tubes, 

202. 
Plant  seeds  and  X-rays,  320. 
Polarisation  of  current,  26. 
Polonium,  351. 
Pole-finding,  217. 
Potential,  6,  8.  10. 
Potential-difference,  9. 
Primary  coil,   52. 

Protozoa,  action  of  X-rays  on,  320. 
Prurigo,  298. 
Psoriasis,  237,  296. 


Quantity,  7,   12. 


Q 


R 


Radiochrometer,  206,   245. 

Radium,   351. 

Radium-rays,  190. 

Ramification  of  current,  36. 

Rays,   short-waved,   383. 

Red-room,  456. 

Reflex-excitability,  influenced  by  X-rays, 

305-  . 
Reflection  of  light,  ;i77. 
Refraction,   378. 
Resistance,  30. 
Resistance,  ballast,  31. 
Resistance,  specific  conducting,  30. 
Resistance,  unit  of,  33. 
Resistance,  external,  34. 
Resistance,  internal,  34. 
Resonator,  Hertz's,  92. 
Resonator,  Oudin's.  95. 
Resonator,  bipolar,  Rochefort's,  96. 
Rheostats,  30. 
Rheostat  lever,  31. 
Rheotome,  57. 
Rheumatism,  304. 

Roentgen-apparatus,  installation  of,  219. 
Roentgen-apparatus,       depreciation      of, 

after  use,  227. 
Roentgen-rays,  187. 
Roentgen  therapy,  229. 
Rotary  current,  51. 
Ruhmkorff  coil,  57. 


Sarcoma,  294,  302,  303. 
Scarlatina,  chromotherapy  in,  457. 
Schulmeister's  interrupter,  69. 
Sclerodermia  after  X-rays,  279. 
Sclerosis,  with  light-treatment.  507,  512. 
Scrofuloderma,  290. 
Secondary  coil,  27,  52. 


INDEX 


531 


Seeds,  germinating  power  of,  355. 

Selenium.  376. 

Self-induction.   54. 

Self-induction,  co-efficient,  55. 

Self-potential,  55. 

Sensitometer.  375. 

Shimmering  light,   117. 

Short  current,  27. 

Short-circuiting  of  coils.  227. 

Shunt  circuit.  38. 

Siemens'  double-T-magnet,  49. 

Siemens'  dynamo,  49. 

Siemens'  interrupter,  80. 

Simon-interrupter,   79. 

Sinusoidal-currents,    104. 

Skiameter,   206. 

Skin,  atrophy  of  after  X-rays,  278. 

Skin  diseases.   174. 

Sleep-movements,  398. 

Solenoid,  45. 

Sound  waves.  200. 

Spark-discharge,  stimulating  action  of, 
121. 

Spark-discharge,  delay  of,  353. 

Spark-gap.  64. 

Spark  inductor.  56. 

Spectroscope.  383. 

Spectrum,  381.  386. 

Spectrum,  cold-lines  in,  387. 

Spintemeter,  345,  525. 

Staphylococcus.  316. 

Subjective  phenomena  after  X-ray  irra- 
diation. 255. 

Sun-baths,  453. 

Sulphate  of  lead.  351. 

Sycosis,  237,  266. 

Sycosis  parasitaria,  271. 


Telangiectasis  after  X-rays,  279. 

Tension,   terminal.  37. 

Tension,  surface.  7. 

Tension  connection,   15. 

Tesla-currents,  89. 

Therapeutical  application  of  high-fre- 
quency currents.  165. 

Thermo-electric  current,   44. 

Thermo-pile.  217. 

Thorium.  351. 

Thrombosis.  301. 

Transformer,  Tesla's,  88. 

Transparency  of  tissues,  425. 

Transverse  vibration,  197. 

Trichotylosis,  262.   271. 

Tropho-ncurotic  theory,  334. 

Tul)crculidcs.  280. 

Tuljcrcular  ulcers.  290. 

Tuberculosis  of  bone,  healed  under  X- 
rays,  304. 


Tuberculosis    with    light-treatment,    454, 

512. 
Tuberculosis  of  lungs,  treatment  by  X- 

rays.  305. 
Tuberculosis   treated   by   high-frequency 

currents,  170. 
Tubes,  Roentgen,  degree  of  hardness  of, 

205. 
Turbine,  mercury  interrupter,  69,  72,  73. 


U 


Ulcus  perforans,  291,  295. 

Ulcus,   rodens,   291. 

Ulerythema  sycosiforme,  267. 

Ultra-red  rays,  383. 

Ultra-violet  rays,  325,  383. 

Ultra-violet  rays,  discharging  properties 

of,  195.  390. 
Ultra-violet  light,   190. 
Unit  of  resistance,  33. 
Unit  of  electro-motive  force,  33. 
Unit  of  current  capacity,  33. 
Unit  of  light.  373. 
Uranium  salts.  351. 
Urticaria  pigmentosa,  301. 


Vacuolisation,  155. 

Vacuum,  205. 

Vacuum  penetrator.  203. 

Vacuum,   IMiiller-Uri,   203. 

Vacuum,   Voltohm,   204. 

Vacuum,  M.  Levy.  204. 

Vacuum,   Dessauer,   204. 

Vacuum,  with  water-cooling,  204. 

Vacuum-tubes,   201. 

Vacuum-tubes,  adjustable,  208. 

Vacuum-tubes,  regulation  of.  208. 

Vaciuun-tubes.  arrangement  of.  224. 

Vacuum-tubes,   importance   of  condition 

of.  242. 
Variola,  chromothcrapy  in,  457. 
Verrucae,  301. 

Visceral  complications  after  X-rays,  307. 
Vitiligo,  420. 
Volt,  9,  33. 
Volta  induction,  52. 
Voltmeter,  39. 
Voltholm-tubes,  204. 


w 

Wehnelt's  interrupter,  59. 

Wheatstone's  bridge,  37. 

Whirl  currents.  56. 

Wind,  electric,  7.  113. 

Work  of  electric  current,  22,  33. 


S32 


INDEX 


X 

X-ray,  stimulating  effect  of,  320. 
X-rays,  elective  action  of,  284. 
X-rays,  the  nature  of,  196. 
X-rays,  penetrating  power  of,  187. 
X-rays,  physical  properties  of,  188. 
X-rays  action  on  fluorescing  bodies,  187, 

191. 
X-rays    action    on    photographic   plates, 

187,  192. 


X-rays    action    with    varying    distance, 

192,  196. 
X-rays,   chemical   action  of,    194. 
X-ray  apparatus  installation,  215. 
X-ray  method  of  treatment,  243. 


Zeemann's  phenomenon,  391. 


LIST  OF  AUTHORS 


Abney.     385.     386,      466. 

483- 
Abraham,   P.  S.,  300. 
Aducco,  443. 
Afanasjew,  351. 
Akopenko,  459. 
Albers-Schonberg.        TJ, 

205,  248,  259,  266,  269, 

282,  286,  289.  296.  327. 
Ames,    325. 
Andre,   486, 
Andresen,  376. 
Angelucci,  437. 
Anthony,  W.  A.,  187. 
Apery,   472. 
Apostoli,    107,    140,     166, 

168,  326,  348. 
Arago.    119. 
Arloing,  402. 
Arnold,  414. 
Aron.  46. 

Aronstam,    N.    H.,   290. 
d'Arsonval,     79,      90-95, 

100,    104-113,    121,    125. 

132,  140.  167,  223.  310, 

328.  387,  402,  438. 
Aschkinass,  xv,  199,  319, 

354- 
Auerbach,  412. 
Aufrecht.  468,  473. 
Ausset,  304. 
Axenfeld,  308,  322. 

Backman,  457. 
Baedeker.     104,     108- no, 

167.  173- 
Bagge,   Ivar,  290. 
Balmain,    520. 
Balthasard,    326. 
Balzer,    279. 
Bang,  404-407,   449-   463, 

485.  499,  501,  508,  511. 
Banister,  239. 
Barbensi,  512. 
Bardet,   309. 
Barlow,  449,  456. 
Barthelemy,      174,      248, 

256,  279,  281,  307,  334- 
Bary,  352. 
Basch,  no,  114, 
Batelli,  200. 


Baudet,    178. 
Baudouin,  500.  509. 
Baxcndell,  450,  452. 
Bazy,  304. 
Beard,   114. 
Beauregard,  313. 
Bechard,  442. 
Bechderews,     427,     443, 

459- 
Beck,  313,  403. 
Beck,   C,  302. 
Beclard,  409. 
Beclere,  245,  525. 
Becquerel,    44,    190,    351, 

361,  385,  464,  520. 
Bedard,  304. 
Beer,  B.,   184,  310. 
Behrend,  29,  252,  279. 
Beijerinck,  409. 
Below,   468,   472,   509. 
Benedikt,  166,  248,  280. 
Benkert,  457. 
Benoist,  206,  245,  257. 
Berg,   Otto,   191,  231. 
Bergman,  248. 
Bergonie,  304. 
Berliner.   421,   449,   456. 
Berlioz,   106,  313. 
Bernard,  245. 
Bert.  413.  418.  445. 
Berthclot,    165,   352,   513. 
Bcrthold,  410. 
Bcrtin,   308. 
Berton,  313. 
Bcsnier.  267. 
Beurmann,  494. 
Bidder.  442. 
Bie,    405.    443,    445,    457, 

508. 
Bicr.  502. 
Billings.  403. 
Bine.  460. 
Bisserie.    112,    174-177. 

180,  248. 
Black.  449. 
Blaikie.  313. 
Blaise.  313. 
Blanc.  454. 
Bloch,  363. 
Blunt,  402. 
Boas,   69, 


Boczar,  250.  266. 
Boeder,  408,  472. 
Boese,  28. 

Boisseau  du  Rocher,  173. 
Bois-Reymond,   419. 
Boll,  437- 
Bollaan,   174. 
Bolleau,    292. 
Bolton,  140. 
Boltzmann.    197. 
Bonetti.   95. 
Bonome,  ni.  140,  313. 
Bordier.    174.  335.  509. 
Bordin,  400. 
Borrisow,  439. 
Bouchacourt,  L.,  85,  115. 
Bouchard,   166,  422. 
Bowles,  324.  422. 
Brahams,   Ph.,   183. 
Brandes,  309. 
Bremer.  481. 
Broca.  239.  486. 
Brooke,  A.  G.,  294. 
Brocq.  174-177,  506. 
Brown-Sequard,  414, 

441. 
Briicke,   418. 
Buchner.  403.  408. 
Budge,   414. 

Biidinger.   Th.,  414.  437. 
Biittner.   187. 
Bukofsky.   266. 
Bum,    167. 

Bunsen,  24,  375.  464. 
Burci,   140. 
Burgsdorf,  508,  511. 
Burnett.   413. 

Caffarena.    no. 
Cailietet.  n8. 
Caldcronc,  265. 
Caldwell.  79. 
Camp  de  la.  294. 
Campenon.  305. 
Camus,  L.,  447. 
Candler,  472. 
Capranica.  .305. 
Capriati.   164. 
Caprioni.  518. 
Carmichael,    195. 
Carre,  17, 


534 


LIST  OF  AUTHORS 


Carvalho,   109,   114. 
Caspari,  W.,  xv,  319. 

357- 
Cattani,   404. 
Cauchy,  382. 
Chabaud,    193,   215. 
Chabry,  174. 
Chalupecky,   309,  311. 
Chamberlain,  292. 
Chanteloube,  304. 
Chatzky,  164. 
Charcot,  44. 
Chardonnet   de,   389. 
Charpignon,  448. 
Charrin,   no,   140,  402. 
Chassanowitz,    440. 
Chatin,  486,  500,  509. 
Chatiniere,  457. 
Chaves,  Br.,  271. 
Chmiliewsky,  402. 
Ciechansky,  454. 
Cohen,  414. 
Cohn,    T.,    3,    108,    no, 

140,   168,   173. 
Clark,  23^  289,  302. 
Claudet,  458. 
Cleaves,  472. 
Colardeau,  207. 
Colleville,  295,  465. 
Colombo,    181,  472. 
Conrad,    238. 
Corrado,  158. 
Cornu,  383,  389. 
Coudres,  Th.  des,  199. 
Cooks,  E.  H.,  513. 
Crookes,    189,    197,    208, 

351- 
Cruet,  167. 
Curie,  351,  361. 

Daitsch,  J.,  441. 
Dandrieu,  402. 
Daniel,   J.,   24,   238. 
Danielewsky,   B.  J.,   164. 
Danlos,   363. 
Darbois,  426. 
Darieix,  309. 
Darier,  307,  310,  340. 
Davenport,  161. 
Davy,  479. 
Denoyes,  107. 
Debierne,  351. 
Deprez,  65. 
Descamps,  304. 
Despeignes,  302. 
Dessaignes,  426. 
Dessauer,    F.,   29,   63-66, 
204,  2 IS,  245,  250,  525. 
Destot,    115,    141,    304. 
Dewar,   386. 
Didsbury,  167. 


Dieudonne,   403-408. 
Dobereiner,   118. 
Dogel.  444- 
Donath,  B.,  34,  187,  200, 

221. 
Dore,  E.,  506,  508. 
Dorn,   354. 
Dort,  van,  290. 
Doumer,    85,     104,     no, 

168,   180. 
Doutrelepont,    288. 
Downes,  402. 
Drigalsky,  473. 
Drossbach,    G.    P.,    389, 

405.  484. 
Drummond,   388. 
Dubard,    115,   141,   304. 
Dubois,  in. 
Ducastel,    290,    304,    497, 

509- 
Duclaux,   402. 
Ducretet,  E.,  95,  208. 
Dumstrey,   280. 
Dupre,   437. 
Dworetzky,      408,       443, 

459,   463,    478. 

Ebert,  H.,  188,  190. 
Eder,    J.    M.,    187,    192, 

205,  230,  324,  335,  356, 

369,  375.  386,  394-  425. 

450,  458,  462,  465,  483, 

521. 
Edwards,  W.,  409. 
Ehlers,    508. 
Ehrmann,    S.,    176,    237, 

243,  253,  270,  275,  280, 

294,  338,  348.  419.  477- 

502,  509. 
Egau,   P.  R..  290. 
Einthofen,    105. 
Eisenlohr,   383. 
Eijkman,   P.  H.,  302. 
Eliot,  324. 
Elster,   351. 
Engel,  457. 
Engelniann,      161,       403, 

411,  437- 
Ernecke,   65. 
Escherich,  304. 
Esselbach,   383. 
Esmarch,    v.,     403,     408, 

512. 
Eulenburg,  439. 
Exner,   F.,   19. 
Exner,      S.,      xiii.,      386, 

419. 


Faraday,  25, 

113,    116. 
Fatigati,  402. 


92,   105, 


Faure,  27. 

Feddersen,  16. 

Feilberg,  457. 

Feldman,   482. 

Fere,   Ch.,   184,  443,  460. 

Ferguson,  293. 

Festner,   457. 

Finsen,  U.,  25,  48,  92, 
105,  275,  284,  369.  405, 
410,  417,  421,  426,  430, 
438,  449,  455.  458,  463, 
478,  483,  488,  492,  498, 
501,  506,  509,  512. 

Fiorentini,  313,  316. 

Fizeau,  57,  458. 

Flammarion,  397. 

Flemming,   176. 

Forchhammer,  505,  508, 
510. 

Forster,  239,  241,  312. 

Foucault,  47,  56,  66,  68, 
458. 

Foveau  de  Courmelles, 
85,  169,  186,  239,  245, 
290,  310,  325,  327,  449, 
474,  490,  496,  509. 

Frankenhauser,    F.,    369. 

Franklin,  90,  94,   119. 

Frantzius,   313. 

Fraunhofer,  383,  386. 

Friedenthal,  140. 

Frister,  230. 

Froscani,   140. 

Fubini,  440. 

Fuchs,   E.,  437. 

Fuchs,   S.,  310. 

Gadeau,  279.  364. 

Gadnefif,  426. 

Gaiffe,  121. 

Gaillard,  403. 

Gaisberg,    S.,  v.,   481. 

Gaudil,   171. 

Garbaso,  200. 

Gassiol,   188. 

Gassmann,  xiv.,  155,  206, 

243,  247,  252,  269,  287, 

289,  341. 
Gastou,     174,     250,     257, 

266,  269,  306,  500,  509, 

525. 
Gatschowsky,  478. 
Gatti,   310. 
Gaugain,  117,   119. 
Gaule,   J.,   443. 
Gautier,    106,   178,   300. 
Gebhard,   309,    369,     408, 

426,  440,  466. 
Geissler,     89,     188,     402, 

517- 
Geitel,  352. 


LIST  OF  AUTHORS 


535 


Gendercn,  437. 

Genoud,    313,    3i5-    449> 

496.  509- 
Geyser,  289. 
Giesel,  35-2-359- 
Giesson,    152. 
Gilchrist.   32^,,   340. 
Gilmanii,  John  G.,  302. 
Gintl,   iq8. 
Giunti,  403. 
Glatzel,  495. 
Glebowsky.      xiii.,       155, 

416.  449,  501.  504. 
Gocht,  187,  252.  281,  289, 

327. 
Godnew,   410,   441.   443. 
Goethe,   444,   460. 
Gorl,   449,   514. 
Goldstein,   xv.,    114,    189, 

336,  352. 
Golgi.    159- 
Gorbazewicz,  442. 
Gottstein,    140. 
Graber,  413. 
Graetz,  L.,  381,  481. 
Graf,   Ch.,   183. 
Graffenberger,    439.    442. 
Greiner    and    Fricdrichs, 

207. 
Grenee,  183. 
Gross,  313. 
Grouven,    243,    250,    263, 

269,  280,  287,  289,  358. 
Grunmach,    3,    280,    289. 

295,  303,  313.  362. 
Guarinoni,  409. 
Guelcher,   28,   44. 
Guichard,  309,  313. 
Guillaume,   107. 
Guilloz,   Th.,    108.    168. 
Gundelach,  207,  213,  245, 

316. 
Gyllenkreutz,   440. 

Hagen,  28. 

Hahn,  237,  248,  266.  269, 

280.   286,    296. 
Hall-Edwards,    250,   289. 
Haller,    iii. 
Hallopcau,  279,  364. 
Hallvvachs,   .389. 
Hammer,  422,  448. 
Hammond,    442. 
Hankcl,  462. 
Harless,   414. 
Harrington.    412. 
Harris,   118. 
Hartley.  389. 
Havas,  250,  281. 
Heggcr,  437. 
Helmholtz,    xi. 


Hemptinne,  A.  v.,   194. 
Henocque,   107. 
Hermann,    184.    421. 
Herschel,  387.  458. 
Hertz,  H.,  x,  87,  92,  189, 

199.  370.  390. 
Hertzog,  482. 
Hess.  C.,  157. 
Himmel,  286,  289,  311. 
Himstedt,   F.,     120,    352, 

361.  437- 
Hirschmann,  W.,  72,  yj, 

212,   245. 
Hittorf,     W.,     189,     213, 

230. 
Hodge,   157. 
Hofmann,   K.   A.,   351. 
Holetschek,  452. 
Holland,  290. 
Holmgren,  437,  440. 
Holzknecht,  G.,  190,  237, 

273^  313.  319,  334,  445, 

525. 
Hoorweg,  L.,   105. 
Hoppe-Seyler,  418,  438. 
Hortatler,   427. 
Huber.   A..   492. 
Hueter,   282. 
Huggin,   386. 
Humphreys,  391. 
Hurtado,  G.,  512. 
Huyghens,  369. 
Hummel,  41. 

Ishewsky,  183. 

Jackson,  202. 
Jacquet,   177,  509. 
Jadassohn,  290,   508. 
Jaksch,    v.,    460. 
Jankau,   326,   335- 
Janowski,   402. 
Jaquot,   177. 
Jaumann,  xv,  353. 
Javal,  362. 
Jegorow,   444. 
Jellinek,     S.,     158.      160, 

165. 
Jency,  290. 
Jcrsild,  O.,  509. 
Johnson,  292,  302. 
Johnston.  James  C,  279. 
Joseph.  H..  xiv.  243,  321. 
Joseph,  Max,  502. 
Jones,  B.,  290,  437. 
Josing,  E.,  401. 
Joussct,  408. 
Jutassy,     237,     248,    260, 

277,  281,  289,  295,  300, 

340. 


Kahane,    Max,    171,    173. 
Kaiser,  G.,  178,  230,  250, 

259,  479- 
Kalischer,    187. 
Kaposi,     236,     250,     268, 

270,   299,   2,23,  335- 
Kattenbracker,   468,    472, 

509- 
Kaufmann,    x,    xiii,    196, 

199,  206,  354. 
Kayser,  xv,  3,  369,  386. 
Kellog,     449,     466,     468, 

489. 
Kelvin,  Lord,  102,  197. 
Kessler.  478. 
Kibbe,  340. 
Kienbock,   205,   237,   242, 

248,  257,  272.  275,  281, 

305,  312,  319,  329,  338. 
Kime,   427,   494. 
Kindler,   169.,  174. 
King,   E.   E.,  238. 
Kirchhoff.     G.,     86,     87, 

383.  386. 
Kiribuchi,    157. 
Kirmisson,   290,   304. 
Kistiakowsky.   xiv. 
Kjeldsen,  486,  509. 
Klemm,    156.    161,  402. 
Klcmperer.  140. 
Knox.  290. 
Koch,   403,   502. 
Korner,   F.,  3,  369. 
Kogan.   B.,   441. 
Kohl,  Max,  99,  121,  223, 

250. 
Kohlrausch,  20. 
Kolle,   238. 

Kondratievv,    408,    473. 
Kopp,   229. 
Kotliar,   402. 
Korybut-Daskicwicz,  157 
Krcidl,   A.,   310. 
Kromayer,  509. 
Krohn,  457. 
Kriiger,    140. 
Krukenberg,  457. 
Krusc,  402,  405. 
Kiihnc,    156,   436. 
Kiinnnel,    237,    282,    289, 

327.  507. 
Kurella,  H..  85,  96,   106, 

164. 
Kurlbaum,   F.,   204. 
Kutschuck,   473. 
Kuznitzky,    183. 

Labarsch-Ostertag,    140. 
Lablx',    107. 
Lacaillo,    107. 
Lahmann,    449. 


536 


LIST  OF  AUTHORS 


Lamberts,   157. 

Lampa,   A.  V.,  ix,  x,  3, 

391,   521. 
Lancashire,   G.   H.,    269, 

281,  285,  290,  293. 
Lancaster,  304,  305. 
Lang,  E.,  502. 
Langley,  387,  451. 
Lapinski,  290. 
Laquer,  474. 
Laquerriere,  140. 
Larsen,  A.   L.,  376,  403, 

483,  508. 
Lassar,  O.,  369,  5o8. 
Laulanie,  no. 
Lazat,   106. 
Learning,  412. 
Lebon,   506,  509,   510. 
Lecercle,  306. 
Leclanche,  24. 
Lecher,  E.,    xv,  3,87, 120. 
Leeds,  483. 
Ledoud-Ledard,  403. 
Leduc,   St.,  85,  no,  516. 
Lemstrom,  165. 
Lenard,     Ph.,     189,    191, 

199,  390. 
Lengyel,  v.,  352. 
Lenz,  49,  56. 
Leonard,       Lester,     210, 

326. 
Leredde,  177,  507,  511. 
Leroy,  L.,  72. 
Lesser,  502,  508. 
Lewandowsky,    114. 
Levack,  J.  B.,  293. 
Levy,    Max,    63,    70,    71, 

74,  79,  204,  212,  215. 
Levy-Dorn,  280. 
Leyden,  15,  513. 
Liebermeister,  454. 
Liese,   509. 
Lindholm,  457. 
Lion,   v.,    257,   266,   269, 

271,  282,  289,  300,  338, 

342. 
Llaberia,  300. 
Lodge,  197. 

Loeb,  395,  410,  413,  442 
Loebel,  448. 
Lowenthal,  439,  471. 
Loewy,  A.,  108,  no,  168. 
Londe,   A.,  y2,    187,  201, 

203. 
Lopriore,  320. 
Lortet,  313,  315,  449,  496, 

509. 
Luebbert,  402. 
Lugaro,  158. 
Luraschi,  313. 
L'Orosi,   141. 


Mach,  L.,  494. 
Macintyre,  238. 
Mackenzie,  408. 
Macleod,  M.  H.,  5n. 
Magini,    157. 
Maier,  M.,  361. 
Majorana,   195. 
Makawejew,  478. 
Maklakow,       416,      422, 

423- 
Maldiney,   320. 
Mann,    158. 
Mangin,   378. 
Maragliano,  V.,   105. 
Marangoni,  193. 
Marcuse,  J.,  447. 
Marcuse,  W.,  229,  238. 
Marmier,   141. 
Marti,  439. 
Martin,  449. 
Martinaud,  403. 
Martre,    107. 
Mascart,  n8. 
Masch,  C,  451. 
Masson,  119. 
Mauduyl,  114. 
Maxwell,    Clark,   87,   92, 

370. 
Mehl,   449,   461. 
Meidinger,    24. 
Mendelsohn,    140. 
Meril,  292,  302. 
Merk,  L.,  250. 
Mery,  P.,  305. 
Meyer,  St.,  352. 
Michelson,   200. 
Mies,  J.,  239. 
Minck,  313. 
Minich,  K.,  277. 
Minin,  472,  478. 
Mizuno,  T.,  58. 
Mohler,  391. 
Moller,     M.,     187,     291, 

324,  369,  415,  419.  432, 

440,  449,  468,  490. 
Moleschott,  419,  440,  448. 
Moment,  403. 
Monckhoven,   464. 
Mongour,  304. 
Monseaux,   279. 
Morgan,  293. 
:\Iorris,   M.,  506. 
Morrow,  P.  A.,  290. 
Morton,  85,  293. 
Mosso,  443. 
Moutier,   109,   168. 
Miihsam,  313,  316. 
Miiller,  122,  187. 
Miiller,     C.    H.    F.,   208, 

395- 
Miiller,  E.  K.,  182. 


Miiller,    G.   J.,    250,   310, 

494,  501,  502,  5n. 
Miiller,  H.,  414. 
Miiller-Pouillet,   3,   369. 
Miiller-Uri,  R.,  203. 
Muraoka,  ix,  200. 
Mygind,  457- 

Nagel,  W.  A.,  361,  487- 
Narkiewicz-Jodko,   181. 
Neisser,  283,  288,  502. 
Neef,  65,  67,  119,  220. 
Nesnamow,  E.,  463. 
Neumann,  L  V.,  85,  176, 
266,  274,  285,  289,  300. 
Newman,  289. 
Newton,  370. 
Nicolou,  257,  270. 
Niels,  369. 
Nikolski,    172. 
Nissell,  159. 
Nobele,  J.  de,  290. 
Nor  ley,  517. 
Novak,  v.,   192. 

Ognefif,  416,  436. 

Oleinikow,  G.,  460. 

Oppolzer,   E.   v.,  451. 

Ortt,  200. 

Ott,  149. 

Otterbein,  449,  461. 

Oudin,  85,  92-104,  iio- 
112,,  132,  167,  174,  223, 
248,  256,  281,  307,  311, 
328,  334,  339,  348,  364, 
525. 

Pacinotti,  355. 
Palaz,  481. 
Paltauf,  491. 
Pansini,  402. 
Parker,   413. 
Parville,  de,  414. 
Pavitier,  457. 
Payne,  296. 
Pearsons,   174. 
Pease,  D.  H.,  140. 
Pech,  van,  441. 
Peekham,  403. 
Peletier,  396. 
Perdu,  454. 
Perntner,    451. 
Perpens,  437. 
Perrin,  196,   199. 
Petersen,  v.,  508,  511. 
Petri,   129,   135. 
Pettenkofer,  v.,  408,  441. 
Pfaundler,  3. 
Pfeffer,  156. 

Pfluger,  105,  157,  184, 
188,  436. 


LIST  OF  AUTHORS 


S31 


Phisalix,  no. 
Piacentini,  440,  442, 
Pick,  Ph.  J.,  253.  434- 
Pickering,  450. 
Picton,  449,  456. 
Piorry,  449,  456. 
Plante,  27. 
Platten,  v.,  442. 
Pleasanton,  461. 
Plucker,  184,  188. 
Poey,  410. 

Poggendorff,  63,    184. 
Pokitonoff,  237,  300. 
Pollak,  28.  81. 
Poncet.  448,  454. 
Potonie,  395. 
Ponza,  444,  460. 
Porcelli.  355- 
Porter,  205,  208. 
Pott,  313,  441. 
Pollitzer,  J.,  271. 
Prausnitz,  408. 
Pringsheim,   396,  401. 
Prochownik.  140. 
Provazek,    S.,    xiv,    243, 

321. 
Pscheidl,    W.,    3. 
Pugh,  293. 
Puluj,   198.  213,  215. 
Purkinje.  310. 
Pusey,  187,  250,  281,  289, 

293- 

Queen  &  Co.,  208. 
Quenisset,  302,  306. 
Querton,  L.,  108. 
Quincke,  440. 

Raab,  O.,  519. 
Radiguet,  59,  95. 
Radman,  G.  H.,  290. 
Radzikowsky,   164. 
Rasch,  E.,  487. 
Raspe,  402. 
Raum,  J.,  369,  416,  440, 

443.  461- 
Reale,  108. 
Regnier,   167. 
Reichenbach,  Baron,  184, 

460. 
Reid,  323,  326. 
Reinhardt,  414. 
Reinigcr,  31,  71,  85,  250, 

486. 
Remond,  A.,  85,   115. 
Rendu,   304. 
Renzi,  de,  108,  473. 
Reyn,  419. 
Rev  11  let,  326. 
Richardson,   403,   404. 
Richarz,  7^. 


Richer,  P.,  239. 
Ridolfi,  119. 
Riecke,  E.,  330,  369. 
Rieder,     174,     313,     327, 

369,  454,  467,  473. 
Riehl,  238. 
Riess,  119. 
Righi,  195. 

Rinehart,   J.    F.,   293. 
Riviere,    171,   306,   313. 
Rochefort,   O.,   96-98. 
Rockwell.  114. 
Rodari,   182. 
Rodet,  308. 
Rontgen,    191,    196,    201, 

507. 
Roiti,  196. 
Rona,  289. 
Ronchi,  441. 
Rood,  513. 
Roscoe.  450,  464. 
Roth,  C,  523. 
Roth.  M.,  469. 
Rouillies,   304. 
Rouviere,   107. 
Roux,   157,  403. 
Rubens,  x. 
Rubenstein,   286. 
Riihlmann,    1 19. 
Ruhemann,  403,  472,  481. 
Ruhmer,  57. 
Ruhmkorff,  79. 
Ruotte,  245. 
Rusconi,  416. 
Ryn,  508. 

Sabouraud,  274,  508. 
Sabrazes,   213,   306. 
Sack,  A.,  501,  504. 
Sagnac,    195. 
Sainton,   304. 
Salomon,  279,  346. 
Salmonsen    -    Wertheim, 

59- 
Sambuc,  313. 
Santori,  402. 
Scharling,  441. 
Schaudinn,  xiv,  320. 
Schanni,   K.,  392. 
Schein,     250,     254,     257, 

264,  301,  348,  506. 
Schcll,  289. 
Schenk,  403. 
Schcnkcl.    206,    247,    252, 

2(x),  289. 
Schickhardt,  403,  408. 
Schiff,   E.,   175,   178,  230, 

2,^7,  240,  250,  266,  271, 

275,  280,  289,  293,  509. 
Schmid,   CI1.,  250,  289. 
Schmidt,  G.  B.,  190,  230. 


Schmidt,  H.  E.,  442,  499, 

501. 
Schnetzler,  409. 
Scholtz,     237,    248,    252, 

257,  263,  269,  282,  288, 

294.  312,  316,  329,  342, 

502. 
Schouli,  E.,  457. 
Sch rotter,   v.,  464. 
Schuckert,  378,  489. 
Schiiler,   Th.,  457. 
Schiirmayer.  259. 
Schulmeister,  L.,  69,  149, 

474- 
Schumann,   V.,  389.  494. 
Schultz,  242,  313,  403. 
Schweidler,  E.  v.,  353. 
Secchi,    484. 

Scdcrholm,  280,  289,  295. 
Seebeck,  521. 
Seifert  &  Co.,  223. 
Seguy,  G.,  207,  302,  306. 
Sehrwald,    193. 
Sella,  195,  238,  252. 
Selmi,   440,  442. 
Sequeira,  291,   508,  511. 
Serapin,  501,  503. 
Sharpe,     280,     289,    295, 

300. 
Sholefield,   289. 
Siemens,     W.,     49,     I2I, 

485- 
Sigaud  de  la  Fond,  114, 

223,  250. 
Simon.  79,  80,  81. 
Simony,  451. 
Sinapius,   304. 
Sjogren,    237,    280,    289, 

290.   295. 
Smirnow,   140. 
Smith,   289,  293. 
Sokolow,  303. 
Solucha,  427. 
Sonncnburg,   289. 
Sorel,  237,  301. 
Soret,  301. 
Sormani,  313. 
Southgate,  Leigh,  304. 
Spilth.   140. 
Spasski,  N.,  109. 
Spieglor,    266,    269,    500. 
Spieler.  313. 
Spilker,    114.    140. 
Spitalcr,  452. 
Squance,  J.  C,  290. 
Stahl,  400. 
Starke,   H.,   195. 
Startin,  J.,  281. 
Stein,  v.,  478. 
Steinach,   414. 
Stembo,   179,  303. 


538 


LIST  OF  AUTHORS 


Stenbeck,  237,  289,  290. 
Sternthal,   359. 
Stokes,  462. 
Stoney,  xi,  199. 
Storer,  462. 
Strandgaard,  457. 
Stratter,  242,  329. 
Strassburger,  414. 
Strasser,  469,  471. 
Strauss,  177.  35i- 
Strebel,     358,     363,    369, 

404,  425,  428,  439,  449. 

463,  468,  469,  471,  473. 

489,  499,  509,  512,  517- 
Strieker,  491. 
Sudnik,   R.,    171,   I79- 
Sule,  192. 
Swendson,  457. 

Tanger,   346. 
Tappeiner,  H.  v.,  519. 
.Tarkhanoff,  306. 
Taylor,  293,  300. 
Tesla,  N.,  86,  88,  89,  90, 

108,  120. 
Thalen,  323,  328,  386. 
Thayer,  449,  461. 
Thielee,   178. 
Thomson,  J.  J.,  x,  xi,  86, 

118,  195,  199,  324- 
Thompson,     E.     P.,    47, 

187,  284. 
Thouvenin,  320. 
Thurnwald,  290. 
Tichomirow,    478. 
Tieghem  van,  397. 
Tizzoni,  404. 
Torok,     250,     254,     257, 

264,  301,  348,  506. 
Tolomei,  141. 
Tommasi,   513. 
Tourette,   Gilles  de,  460. 
Tripet,  107. 
Triwus,  443. 
Trouve,  473,  494,  496. 
Tschdanow,  179. 
Tudor,  28. 
Tuma,  J.,  328. 


Turner,  478. 
Tyndall,  385,  402,  437. 
Ufifelmann,  408. 
Ullmann,    K.,    281,    300, 

408. 
Upensky,  478. 
Uskofif,  412. 
Unna,    P.    G.,    152,    I55, 

259,  340,  415,  421,  449, 

456. 
Valenta,  E.  V.,  142,  192, 

205,  324,  335,  425,  429, 

462. 
Valenza,  158. 
Vas,  157. 

Vedding,  W.,  487. 
Veiel,  449-  454,  456. 
Verworn,  156,  412. 
Vial,   140. 
Vieira,  250,  257. 
Vietti,  G.,  108. 
Vigouroux,  114. 
Villard,  P.,  194,  245,  354- 

525- 
Villari,   196,   352. 
Vinaj,  G.  S.,  108. 
Viola,   no. 
Vogel,  H.  W.,  369,  482, 

489,  517. 
Voigt,  302. 
Voit,  441. 

Voller,  yy,  189,  192. 
Volta,  19. 
Vosmaer,  200. 

Wade,  313. 

Wagner,  516. 

Walker,    Norman,     266, 

290. 
Wallentin,  J.  G.,  3,  18. 
Walkhoff,   358. 
Waller,    A.,    397. 
Walsh,  307. 
Walter,  B.,  3,  54,  60,  77, 

116,  133,  192,  200,  205, 

210,  214.  336.  354,  456. 
Ward,      Marshall,      402, 

405,  513. 


Warnecke,  376. 
Wassilief,   172. 
Waterhouse,  459. 
Waters,  449,  456. 
Watson  &  Sons,  203. 
Weber,  40. 
Wedding,  420,   520. 
Wehnelt,  A.,    59-62,    y;},- 

79,    94,    100,    120,    191, 

200,  212,  217,  221,  247. 
Weichselbaum,      A.     V., 

113,   122. 
Weigert,    152,   288,   341. 
Weldor,  302. 
Widmark,  416,   422,  433, 

448,  462,  490. 
Wiechert,  E.,  199. 
Wiedemann,    E.,    3,    1 16, 

119,   188,  385. 
Wien,  W.,   199. 
Wiesner,  396,  451. 
Wild,  203,  214,  311. 
Wilke,  217. 
Wilkinson,  114. 
Williams,  Chisholm,  175, 

293- 
Wimshurst,  18,  120. 
Winkelmann,    196. 
Winkler,   F.,  85. 
Winogradsky,  408. 
Winternitz,  W.,  456,  469. 
Wittich,  419. 
Wittlin,  313,   403,   408. 
Wolters,    421,    449. 
Wolff,'  M.,   313- 
Wollaston,   393. 
Wood,  N.,  280,  300. 
Woyzekowsky,  327. 
Wwedensky,  413. 

Young,  370,  409. 

Zarubin,   187. 
Zechmeister,  250,  271. 
Zeemann,  199,  231. 
Zehmann,   347,   391. 
Zeit,   319. 

Ziemssen,    v.,    237,    266 
289,  295. 


NOTES 

O  N 

INSTRUMENTATION 


(Published  in  connection  with  the  English 

Translation  of  RADIO-THERAPY, 

by  LEOPOLD   FREUND) 


BY 
Clarence  A.  Wright,  F.R.C.S.(  E.),  F.F.P.S.G. 

Member  of   the  Rontijeii  Society,  and  of  the  Britisli  Electro-thera- 
peutic Society,  Associate  Editor  of  tlie  Journal  of  Medical 
Electrology  and   Radiology,  etc. 


ILLUSTRATED 


NEW  YORK 
REBMAN    COMPANY, 

lo  Wkst  23D  Street,  Cor.  5th  Avenue. 

LONDOM    ACJENTS  : 

REBMAN,    LIMITED 

129  SiiAi' iKsiUKV   .\\v..,  London,  \V.  C. 

1904 


NOTES  ON   INSTRUMENTATION 


SOURCE  OF  ELECTRIC  ENERGY.— As  the  choice  of  an  electro- 
motor or  source  of  electrical  energy  is  a  matter  of  primary  importance,  it  were 
well  to  preface  our  remarks  on  the  more  recent  advances  in  instrumentation 
by  a  short  preliminary  survey  of  this  subject. 

The  question  first  to  be  decided  by  the  reader,  is  the  form  of  treatment 
that  he  is  desirous  of  adopting.  As  far  as  Phototherapy  goes,  he  must  remem- 
ber that  treatment  by  the  Fiiiscn  Arc  Lamp  requires  a  continuous  current  of 
about  80  amperes  at  50  volts.  A  Finscn-Rcyn  Lamp,  in  working  off  the  same 
current,  consumes  20  amperes  at  55  volts.  Lamps  of  the  Lortet-Genoud  type 
on  a  continuous  current  supply  require  only  one  half  this  amount  of  current, 
but  they  consume  an  additional  6  amperes  when  working  off  an  alternating 
one.  The  little  DcrDio  lamp  of  Dr.  Bang  takes  a  continuous  current  of  about 
60  volts  and  5  to  10  amperes.  The  more  powerful  and  efficacious  Strcbel 
Lamp  consumes  7  amperes  at  50  to  100  volts  on  a  continuous  or  alternating 
main.  It  is  evident  therefore  that  the  form  of  apparatus  to  be  used  for  Pho- 
totherapy must  have  a  considerable  influence  on  our  selection  of  a  source  of 
electrical  energy. 

Again,  for  Radiography  and  Radiotherapy,  we  notice  that  we  require 
a  current  of  very  high  electro-motive  force  (50  to  500  thousand  volts),  but 
of  small  amperage  (1.6  to  10  m/a,  according  to  the  degree  of  vacuum  of  the 
focus  tube).  We  can  obtain  the  necessary  current  direct  from  a  static  ma- 
chine, or  indirectly  by  means  of  some  form  of  Induction-Transformer,  which, 
when  actioned  by  a  current  of  low  voltage,  will  produce  in  its  secondary  cir- 
cuit one  of  the  required  tension.  Inasmuch  as  portability,  or  the  amount  of 
floor  space  available,  is  a  question  of  moment,  Spark  Coils  will  be  found  by 
far  the  most  suitable  form  of  apparatus  for  our  purposes,  more  especially  as 
they  can  also  be  turned  to  account  for  High  Frequency  Treatment.  For  coils 
yielding  a  spark  of  12  to  16  inches  in  air — the  size  most  suitable  for  general 
use — a  current  of  4  to  12  amperes  at  16  to  80  volts  will  be  required,  accord- 
ing to  the  form  of  interrupter  employed. 

It  is  obvious,  therefore,  that  the  source  of  electricity  best  suited  for 
practising  all  these  three  branches  of  Physico-therapeutics  must  be  one  which 
can  furnish  us  with  a  current  of  60  to  80  volts  at  16  to  20  amperes.  The 
problem,  therefore,  resolves  itself  into  a  consideration  of  the  forms  of  elec- 
trical energy  capable  of  furnishing  the  necessary  amount  of  current.  The  re- 
strictions imposed  by  environment  and  the  conditions  of  life,  under  which 
the  practitioner  must  work,  to  a  large  extent  determine  his  choice  of  a  source 
of  electrical  energy. 

In  towns,  where  a  current  from  the  conuncrcial  main  is  available,  he 
is  naturally  anxious  to  use  it.  In  order  to  do  so  it  is  necessary  for  him  to 
ascertain  the  nature  of  the  current  supplied,  whether  continuous  or  alter- 
nating; its  voltage,  and  in  the  case  of  an  alternating  current,  its  frequency  as 
well. 

CONTINUOUS  CURRENTS.— In  working  off  the  commercial  mains, 
where  a  continuous  current  of  100  to  no  volts  is  supplied,  a  sliding  shunt-re- 
sistance or  rheostat,  with  crank  to  vary  the  number  of  volts,  and  a  small  slid- 
ing resistance  to  regulate  the  amperage,  can  with  advantage  be  used.  Where 
a  current  of  higher  voltage  is  laid  on,  the  waste  entaili'd  by  the  use  of  a  rheo- 
stat is  very  great,  and  it  is  more  advantageous  under  ihe  circumstances  to 
employ  the  current  to  work  a  m<it<>r-transformcr  or  to  re-charge  accunuila- 


2  RADIO-THERAl'V 

tors.  For  the  latter  purpose  a  lamp  resistance  may  be  introduced  into  the  cir- 
cuit. As  the  light  of  these  lamps  can  be  turned  to  account  in  lighting  a  hall, 
room,  or  the  wing  of  a  house,  the  large  amount  of  current  flittered  away  in 
making  the  carbon  filaments  incandescent  need  not  add  to  the  expense  of 
working. 

ALTERNATING  CURRENTS.— In  working  off  a  street  alternating 
main  three  methods  can  be  adopted  : 

(a)  The  tension  of  the  current  to  be  employed  can  be  raised  by  a  step- 
up  transformer,  and  a  Koch  rectifier  employed  to  render  it  uni-directional  or 
pulsating. 

(b)  One  or  other  phase  mav  be  suppressed,  and  the  current  rendered 
uni-directional  by  a  rectifier ;  and  employed  to  operate  the  coil  or  to  re-charge 
accumulators. 

(c)  The  current  may  be  transformed  by  means  of  a  motor-transformer, 
for  use  on  alternating  mains. 


Accumulators,     (/v.  S  dial  I,  London.) 


Fig.  lb. 


ACCUMULATORS  (Figs.  la  and  ib).— Where  the  current  from  the 
main  is  not  available,  but  facilities  exist  for  getting  accumulators  re-charged. 
Secondary  batteries,  with  an  individual  cell  capacity  of  45  to  60  ampere-hours, 
may  without  detriment  be  substituted  for  it.  They  can  be  charged  by  means 
of  hand  dynamos  or  Thcrmo-piles,  the  last-named  being  a  source  of  electrical 
energy  whose  possibilities  have  not  yet  been  developed  to  its  fullest  extent. 
The  absolute  constancy  of  the  current  from  the  latter  source  leaves  nothing  to 
be  desired.  They  are  easily  started,  work  vvith  a  minimum  of  attention,  and, 
with  fair  use,  last  for  years  without  requiring  any  repairs.  They  can  be  ac- 
tioned  by  the  heat  from  a  gas,  oil  or  spirit  flame.  Although  miich  has  been 
said  in  favor  of  accumulators  on  the  score  of  portability,  it  must  be  confessed 
that  they  bear  transportation  badly,  being  very  sensitive  to  jars,  while  the 
buckling  of  the  plates,  the  dropping  of  the  lead  and  the  frequent  reburning 
that  the  lugs  require  are  other  sources  of  annoyance.     They  are.  on  the  other 


NOTES  OX  IXSTRiWIliXTATION  3 

hand,  adiiiiralile  as  stationary  storage  batteries.  For  up-country  stations,  like 
India,  wliere  labour  is  cheap,  the  hand  dynamo  shown  in  Fig.  2  is  to  be  recom- 
mended to  charge  accumulators  with.  Where  gas,  oil  or  petroleum  is  avail- 
able as  a  motive  power,  a  dynamo  worked  by  a  I  2  H.  P.  motor  can  be  em- 
ployed. 

CONTINUOUS  CURRENT  DYNAMO.— In  working  otY  an  alter- 
nating street  current,  or  from  commercial  mains  supplying  a  continuous  cur- 
rent at  very  high  voltages  {200  to  .300  volts),  a  rotary  converter  is  an  advan- 
tage.    The  initial  oiUlay  is  iieavy,  InU  it   -^aves  the  needless  llittering  awav  of 


^    "J:^    A--iii-*/y-'-^ 


ll.ind   l)ynani().      il sciillial,  London.) 

current  in  passing  through  a  --hunt  rheostat.  For  working  a  I'inscn  Arc  Lamp 
on  higii  voltage  mains  it  is  indispensal)le.  The  continuous  current  dynamo  is 
always  the  most  suitable  installation  for  up-couiUry  stations;  a  gas  or 
petroleum  engine  furnishing  the  motive  power. 

PRIMARV  BATTERIE.S.— If  this  very  expensive  and  rather  trouble- 
.some  .-ource  of  electricity  is  selected.  :t  nni-~t  be  noticed  that  only  cells  with 
a  very  small  internal  resistance  are  suitable  for  the  purpose.  Even  among 
these,  cells  where  two  different  acids  are  used,  like  the  Himsen  or  drove,  re- 
quire too  nnicb  attention    for   the  pnri)o^e.     We  have,   therefore,   to   fall   back 


XOTES  OX  IXSl^RLWIEXTATJON  5 

on  the  BiLliroiiiatc  cells,  whose  chief  objection  is  their  want  of  constancy. 
To  obviate  this  difficulty,  care  must  be  taken  that  the  two  electrodes  are  suf- 
ficiently far  apart  to  allow  of  the  circulation  of  a  wide  stream  of  acid  between 
them,  and  also  that  they  be  of  the  largest  dimensions  possible,  with  the  zinc 
plates  well  amalgamated.  These  precautions  taken,  the  only  objection  to  them 
is  that  of  expense,  which  is  decidedly  greater  than  that  of  electricity  derived 
from  any  other  source,  currents  of  high  voltage   (lOO  volts)   inclusive. 

Having  so  far  dealt  ^\  ith  the  sources  of  electricity,  we  may  next  con- 
sider Induction  Coils  and  the  accessories  tending  to  their  proper  working,  care 
being  taken  to  point  out  the  factors  upon  which  their  efficiency  depends,  and 
any  drawbacks  attending  their  use. 

INDUCTION  COILS. — Introduced  by  Masson  and  improved  by 
RuhmkoriT,  they  attained  to  a  very  high  degree  of  excellence  in  the  Spottis- 
zvoodc  Coil  (Fig.  3),  which  in  1877  excited  the  admiration  of  the  scientific 
world.  This  coil  was  furnished  with  two  interchangeable  primaries,  in  one 
of  which  the  layers  were  subdivided  and  could,  by  a  novel  mechanical  ar- 
rangement, be  connected  either  in  series  or  parallel.  The  secondary  of  the 
coil  consisted  of  280  miles  of  wire  (w-ith  a  total  resistance  of  110,200  ohms), 
wound  in  four  sections,  the  two  outer  being  of  wire  of  somewhat  larger 
sectional  area.  Each  section  was  wound  in  flat  discs,  of  about  200  layers. 
The  total  number  of  turns  in  the  secondary  was  341,850.  Strange  to  say,  the 
condenser  of  this  coil  was  not  larger  than  that  usually  fitted  to  coils  of  much 
smaller  dimensions.  It  consisted  of  126  sheets  of  tinfoil  (18  x  8^4  inches)  sepa- 
rated b\^  a  double  layer  of  varnished  paper  about  one-hundredth  of  an  inch 
thick.  The  coil,  with  5-quart  Grove  cells,  gave  a  spark  of  28  inches  of  air; 
with  10  similar  cells  one  of  35  inches;  and  with  30  such  cells  sparks  ranging" 
from  syyi  to  42  inches.  It  is  evident,  therefore,  that  even  as  early  as  the  year 
1877,  the  principles  underlying  the  manufacture  of  large  coils  were  well  under- 
stood in  England. 

Although  passable  Radiographic  work  has  been  done  in  the  field  with 
coils  of  smaller  size,  those  most  suitable  for  the  purpose  should  yield  a  spark 
of  10  to  16  inches  in  air.  In  the  selection  of  coils  one  has  first  to  consider 
their  efficiency,  the  value  of  the  materials  and  devices  used  in  their  construc- 
tion, and  lastly,  the  arrangements  that  exist  to  lit  them  to  the  varying  con- 
ditions of  focus  tube  vacuum,  and  of  the  interrupter  employed. 

EFFICIENCY. — The  true  criterion  of  efficiency  is  the  amount  of  elec- 
trical energ}'  that  can  be  transformed.  This  quantity  is  the  product  of  two 
factors;  the  electro-motive  force  and  the  amperage  of  the  derived  current. 
The  former  determines  the  spark  length  of  the  secondary  circuit ;  the  latter 
can  roughly  be  gauged  by  the  number,  brightness  and  thickness  of  the  sparks 
passing  between  the  knobs  of  the  discharger;  so  that  with  coils  giving  sparks 
of  the  same  length  we  may  say  that  the  one  which  produces  the  greatest 
number  of  fat.  bright  sparks,  is  the  best.  In  deciding  this  point,  it  is  impor- 
tant to  remember  that  tlic  voliiinc  of  sparks  of  iiia.viiiiitm  length  and  intensity 
must  be  obtained  n'ith  a  rela'iz'ely  high  number  of  interruptions  (800  or 
more)  per  minute. 

CONSTRUCTION  OF  COILS.  (Figs.  4  and  5)  The  utility  of  a 
spark-coil  for  heavy  discharges  depends  upon  two  factors,  namely,  the  perfec- 
tion of  its  insulation  and  the  quality  of  the  materials  used  in  its  construction. 

INSULATION  of  the  various  parts  is  secured  by  the  use  of  hard  rub- 
ber or  ebonite  tubes ;  that  of  the  various  sections  and  layers  by  the  use  of 
hard  paraffin  wax,  or  better  still,  by  employing  a  semi-solid  viscid  hydrocarbon 
similar  to  that  used  as  an  insulator  in  the  Rochefort  Transformer.  The  in- 
sulation of  the  wires  of  the  primary  and  secondary  is  best  carried  out  by 
using  only  the  best  double  silk-coated  wire  in  the  construction  of  these  parts. 
The  perfection  of  insulation,  on  the  whole,  may  he  said  to  depend  upon  the 
exclusion  of  air,  whose  inferiority  as  an  insulator  to  the  hydrocarbons  is  too 
well  known  to  require  comment.  Some  makers  endeavor  to  secure  this  by 
prolonged  immersion  of  the  wires  in  melted  wax,  renif'ving  the  excess  in  wind- 
ing. This  plan,  however,  is  too  crude  to  be  entirely  relied  upon,  so  the  various 
parts,  when  wound,  have  to  be  again  treated  to  a  bath  of  the  same  material. 
Others  employ  methods  better  fitted  to  secure  ])erfecl  insulation,  but  these  are 


RADlO-THBRAPy 


carefully  guarded  as  trade  secrets.  The  use  of  cotton  for  coating  the  con- 
ducting wires  is  in  every  way  to  be  condemned.  It  is  a  pity  to  sacrifice  ef- 
ficiency for  the  sake  of  a  slight  reduclion  in  the  price. 

THE  QUALITY  OF  MATERIALS.— All  materials  used  in  the  manu- 
facture of  Heavy  Discharge  Induction  Coils  should  be  of  the  best  quality. 
Soft,  well-annealed  iron  is  best  suited  to  minimize  loss  of  power  by  hyster- 
esis.    Lamination  or  division  of  the  metal  core  in  a  direction  parallel  to  the 


flow  of  magnetism,  coupled  with  insulation  of  the  adjacent  plates  or  wires  with 
thin  paper,  varnish  or  parafiin  wax,  will  reduce  the  Eddy  currents  to  an  al- 
most negligible  amount.  For  this  reason,  it  is  usual  to  make  use  of  the  best 
annealed  transformer  iron  wire  for  the  cylindrical  core,  on  wh'ch  the  primary 


NOTES  OX  IXSTRrMEXTATJOX  7 

is  woimd  :  insulation  against  Eddy  currents  being  secured  by  thorough  im- 
pregnation with  paraffin  wax  and  sparking  between  the  core  and  primary  by 
binding  round  with  tapes  similarly  treated.  The  wires  employed  for  the 
primary  and  secondary  circuit  should  be  the  best  annealed  double-silk-coated 
copper,  and  not  cotton-covered  wires,  which  are  sometimes  substituted  for  the 
sake  of  cheapness.  Each  layer  of  the  primary  should  be  insulated  from  those 
adjacent  to  it  by  sheets  of  parafiined  paper,  and  the  primary  as  a  whole  further 
insulated  by  inuiiersion  in  paraffin  wax.  It  is  for  the  same  purpose  carefully 
separated  from  the  secondary  by  a  stout  tube  of  ebonite,  which  is  closed  in  at 
both  ends  by  discs  of  the  same  material.  As  the  strain  on  the  dielectric,  due 
to  the  difference  of  potential  between  the  contiguous  turns,  is  diminished  by 
sectional  winding,  the  sub-division  of  the  secondary  into  sections,  each  only  a 
fraction  of  an  inch  in  thickness,  is  a  point  upon  which  stress  should  be  laid 
in  ordering  coils.  Each  section  when  wcnmd  should  be  thoroughly  impreg- 
nated by  soaking  in  hot  paraffin  wax  and  further  insulated  from  the  two  ad- 
jacent sections  by  a  thin  disc  of  ebonite  or  sleeves  of  well-parafiined  paper. 
The  wire  ends  should  be  soldered  with  resin  alone — no  acid  being  used,  and 
the  insulation  of   the  joints   slrengtluncd.   by  binding   over   with   waxed  silk. 


Eh; 


Incli    .Spark    Coil.      (JVatscii    c'r  .V.w/.v.    London.) 


The  coil,  when  complete,  is  usually  fitted  with  ebonite  flanges  and  finished 
with  an  elwnite  cover,  the  ends  of  the  secondary  wire  being  at  the  same  tune 
brought  to  two  brass  terminals,  mounted  on  the  ebonite  cover  or  on  the 
flanges.  To  obviate  the  risk  of  breakage  during  transport  and  to  lessen  the 
strain  upon  the  ebonite  coating,  the  coil  should  be  connected  with  the  box- 
base  bv  suitable  supports.  .... 

In  some  coils  each  section  of  the  secondary  is  sliniud.  a-  it  is  woumk 
over  the  tube  containing  the  luiniarv  w'wc.  and  to  this  lube  the  el)omle  ll.mges 
are  permanentlv  fitted.  In  dtlu's.  the  tube  bearing  the  primary  is  removable, 
and  can  be  withdrawn  and  another  iii-erted  (as  in  Eig.  ()),  so  as  to  niake  it 
suitable  for  use  with  various  interrupters.  The  latter  arrangement  also  facili- 
tates the  detection  and  rerair  of  any  breakdown  in  the  insulation  ot  the  pri- 
mary, without  disturbing  the  wiring  of  the  secondary  circuit. 

In  the  older  type  of  coils  intended  for  use  with  a  plalminn  nUernipler 
on  currents  of  low 'voltage,  the  contact  switch  (  o.ininnl.itor )  and  sparking 
pillars  are  mounted  upon  the  base  board  of  llie  c.il.  I  his  arrangement, 
though  well  adapted  for  the  purpoH's  for  which  it  was  mteiKled,  is  no  longer 
neces^^ary  The  introduction  of  the  more  modern  type  of  mterrui)ters,  work- 
ing f.n  currents  uf  liigber  voltage,  has  led  lo  the  transfer  ot   the  coniiiiutator 


Fig.  6.   Lavge  Coil,  wifli  Condenser.      (Iscnfhal,  London.) 


LOW 


Fig.  7.  Divided  Primary.      (Saiiitas  Elcctl.  Co.,  London.) 


NOTES  OX  IXSTRCMEXTATIOX  g 

to  a  wall  switchboard,  where  all  the  other  regulatory  apparatus  are  gathered, 
the  sparking  pillars  being  at  the  same  time  removed'  from  the  baseboard. 
The  only  reasonable  plea  that  can  be  put  forward  for  the  retention  of  spark- 
ing pillars,  is  that  they  are,  when  fitted  with  the  point  and  disc  discharging 
terminals,  of  service  in  ascertaining  the  polarity  of  the  current.  As  this  can 
equally  well  be  established  by  other  means,  their  use  can  be  easily  dispensed 
with.  This  arrangement,  besides  simplifying  the  coil  and  reducing  its  size, 
commends  itself  to  all  on  tlie  groundwork  of  expediency;  for  it  is  ever  wise 
to  avoid  proximity  with  the  coil  in  adjusting  the  contacts.  The  tendency  to 
convert  the  base  board  of  the  coil  into  a  miniature  switchboard  is  on  the  wane 
(at  any  rate,  in  the  case  of  large  Coils)  and  one  seldom  now  sees  a  large 
coil,  which  consists  of  more  than  the  coil  itself  and  its  condenser,  each  pro- 
vided with  its  own  terminals. 

ADAPTABILITY. — The  two  chief  devices  for  suiting  the  coil  to  the 
varying  degree  of  vacuum  in  the  focus  tube  and  to  the  various  classes  of  in- 
terrupters are  the  arrangement  for  altering  the  self-induction  of  the  primary 
and  that  for  varying  the  capacity  of  the  condenser  of  the  coil. 

The  arrangements  for  altering  the  self-induction  of  the  primary  circuit 


Coil,    Divided    Primary    Carried    to    Base. 
(H.  JV.  Cox,  Ltd..  London.) 


Fig.  g.  "Vril"  Interrupter. 


of  the  coil  followed  the  introduction  ni  the  electrolylic  break.  ]\Iakers  at  first 
tried  to  meet  the  difficulty  by  supplying  coils  with  two  or  more  interchange- 
able primaries  so  as  to  suit  the  self-induction  to  the  various  types  of  inter- 
rupters employed,  but  a  more  scientific  realization  of  the  principle  was  soon 
arrived  at  in  the  sub-divided  primary — the  end  of  the  different  layers  of  which 
are  carried  to  separate  terminals,  which  can  be  connected  in  parallel  or  in 
series,  so  as  to  vary  the  self-induction  to  the  requirements  of  both  tubes  and 
interrupter.  A  device  by  which  these  combinations  can  be  effected  is  shown 
in  Fig.  7,  but  a  more  convenient  arrangement  is  to  carry  the  wires  leading  to 
the  various  layers  to  the  ba.5e  board,  or  to  the  wall  switchboard,  where  they 
can  be  more  convenientlv  altered  without  approaching  the  coil. 

THE  SUBDIVIDFD  CONDI-NSER  (Fig.  8).— The  addition  of  a 
condenser  to  a  coil  was  first  suggested  by  Fizcau.  It  was  primarily  intended 
to  make  the  break  of  the  primary  circuit  tttoic  suddni  and  complete  by  pre- 
venting the  .spark  (due  to  the  extra  current)  from  i)assing  between  the  con- 
tact studs  of  the  interrui)ter.  It  a!-o  serves  another  purpose.  Ry  accumu- 
lating the  energy  of  the  self-induced  extra  current  at  "break"  and  discharging 


10  RADIO-THERAPY 

it.  a  moment  later,  through  the  primary  circuit,  it  hastens  the  demagnetization 
of  the  core,  and  thereby  increases  the  E.  M.  F.  of  the  induced  direct  current  in 
the  secondary  circuit.  The  size  and  capacity  of  the  condenser  are  usually 
proportioned  to  the  maximum  length  of  the  spark,  but  some  coils  are  fitted 
with  a  subdivided  condenser  and  a  mechanical  device  whereby  each  or  all  of 
its  subdivisions  can  be  thrown  in  or  out  of  the  circuit.  This  allows  of  an  ex 
tensive  degree  of  regulation  of  the  size  and  intensity  of  sparks  obtained  from 
the  secondarj'  terminals. 

The  best  types  of  coils  possess  both  these  regulations. 

ACCESSORIES. — The  two  most  important  accessories  for  convenience 
in  working  coils  are  the  commutator  and  the  lead  fuse,  the  latter  being  in 
most  coils  conspicuous  by  its  absence.  The  commutators  most  commonly  used 
with  the  spark  coil  are  the  Rliiiinkorff,  the  dc  IValteville,  the  Sicinens-Halskc, 
the  Castcx.  In  working  with  modern  types  of  interrupters  the  commutator 
is  best  mounted  with  the  other  accessories  on  the  wall  switchboard  or  upon  a 
table  distributor. 

As  much  of  the  efficiency  of  spark  coils  depends  on  the  nature  of  the 
arrangement  for  automatically  interrupting  the  llow  of  the  current  in  the 
primary  circuit,  it  will  be  wise  to  consider  them  at  some  length. 

INTERRUPTERS. — The  chief  type  of  interrupters  in  use  at  present 
are  : 

(a)  The  Vibratory  Interrupter. 

(b)  The  Rocking  IMercury  Interrupter. 

/    \   T-i      7\r  -\T  ^       T   .  i      \  Rotarv  Type 

(f)    I  he  iMercury  Motor  Interrupter-    i-.-       -   n--" 
^   ^  -^  /  Dipper   i  ype 

/j\    n-i      T3   t         -D       1    \T\\c  Brush-Sector  Tvpe 
(a)    I  he  Rotarv  Break  •  rr-i      t 
^    ^  -  i  huni   I  ype 

(c)  The  Electrolytic  Interrupter  -,   t  ■      ■  i  ^ 

■'  {  Liquid  I  vpe 

if)   The  Jet  Break. 

VIBRATORY  INTERRUPTERS.— The  older  type  of  spring  platinum 
Interrupter  is  rapidly  falling  into  disuse,  the  few  remaining  representatives  of 
this  class,  like  the  "Vril"  Break  (shown  in  Fig.  9),  maintain  their  popularity 
for  small  coils  by  reason  of  the  fine  adjustment  which,  by  allowing  the  core 
to  become  nearly  saturated  before  breaking  the  contact,  induces  a  higher 
E.  M.  F.,  in  the  secondary  circuit.  The  difference  in  the  electromotive  force 
which  can  be  thus  obtained  is  very  great,  while  at  the  same  time  the  wear  on 
the  contact-studs,  by  the  sparking  set  up  at  "break"  is  reduced  to  a  minimum. 
It  must,  however,  be  remembered  that  the  heat  so  engendered,  even  if  mini- 
mized, is  not  without  its  effects  upon  the  contact  spring,  the  untempering  of 
which  is  mainly  responsible  for  the  increase  of  sparking.  To  obviate  this 
difficulty,  the  resiliency  of  the  spring  is  now-  abolished  and  the  suddenness  of 
interruption  at  the  point  of  maximum  saturation  promoted  by  a  simple  me- 
chanical device.  A  light  piece  of  flat  metal,  balanced  on  its  edge,  is  substi- 
tuted for  the  movable  contact,  and  is  maintained  in  position,  while  the  cur- 
rent is  passing,  by  spiral  spring,  whose  tension  can  be  easily  regulated.  The 
adjustment  for  contact  duration  is  thereby  increased  and  the  interruptions 
can  be  timed  to  always  occur  at  the  phase  of  maximum  induction. 

The  maximum  voltage  that  can  legitimately  be  employed  with  a  plat- 
inum break,  should  not  exceed  z^^  volts.  For  coils  yielding  sparks  of  18  inches 
and  over,  every  form  of  platinum  interrupter  is  rmsuitable,  as  the  contact 
surfaces  are  too  rapidly  destroyed  by  the  powerful  sparking  which  takes 
place.  In  working  with  these  some  form  of  mercury  break  or  more  modern 
interrupters  should  be  employed. 

THE  ROCKING  MERCURY  INTERRUPTER  is  fast  becoming  an 
object  of  antiquarian  interest.  The  best  model  of  this  group  is  the  "Interrup- 
teur  oscillant  a  movement  rectiligne"  of  M.  Roclicfort.  In  it  the  movement 
of  the  dipper  is  perfectly  perpendicular  to  the  surface  of  the  mercury,  as  may 
be  gathered  from  concentric  rings  that  form  upon  the  surface  of  the  isolating 
fluid.  It  can  furnish  any  number  of  interruptions  up  to  1.200  per  minute.  The 
rapidity  of  oscillation  is  regulated  by  an  adjustable  weight.  The  amount  of 
current  consumed  in  working  it  is  very  small. 


NOTES  OX  IXSTRLMEXTATIOX  ii 

Another  eloctro-magnetic  interrupter  of  tlie  dipper  type  is  that  of 
.1/.  Radigiict.  In  it  both  the  fixed  and  moving  eontacts  are  made  of  copper, 
no  mercury  being  employed.  It  allows  of  a  fair  degree  of  adjustment  for 
contact  duration  and  for  speed,  and  is  by  far  the  best  electro-magnetic  inter- 
rupter with  which  I  am  acquainted. 

THE  MERCURY  .MOTOR  INTERRUPTER  (Dipt^^r  Type)  (Fig. 
lo).  There  are  several  varieties  of  this  interrupter  on  the  market.  In 
all  of  them  an  electric  motor  is  employed  to  effect  the  dip  and  withdrawal  of 
a  platinum  tipped  rod  from  contact  with  the  mercury.  In  a  good  interrupter 
of  this  type,  the  dipper  should  enter  (jiiitc  X'crtically,  so  as  to  prevent  the  stir- 
ring up  of  the  mercury,  which  would  interfere  with  the  accuracy  of  the  inter- 
ruptions. Most  forms  of  rccifroccifiiig  hrcahs  allow  some  degree  of  regulation 
for  contact  duration  (by  raising  or  lowering  the  level  of  the  mercury)  and 
for  controlling  the  frequency  of  interruption  (by  regulating  the  speed"  of  the 
motor).  The  motor  must  be  actioned  by  a  battery  or  circuit  distinct  from 
that  of  the  coil.  Interruptions  ranging  from  800  to  1,200  per  minute  can  be 
obtained,  the  intensity  of  the  discharge  from  the  secondary  terminals  being 


Fig.   10.   Dipper  Interrupter.     (H.  W.  Cox,  Ltd.,  London.) 

most  intense.  They  are  constructed  for  all  E.  M.  1'.  between  12  to  100  volts, 
and  are  almost  noiseless  in  action;  but  are  open  to  the  same  objections  that 
can  be  levelled  against  all  forms  of  mercury  break.  The  mercury  after  a  time 
requires  cleaning;  for  the  intensity  of  the  spark  in  the  contact  space  tends  to 
oxidize  it,  and  by  so  doing,  to  hamper  the  suddenness  of  the  break.  This  is 
more  especially  the  case  when  run  with  a  current  of  high  voltage  upon  the 
primary  of  the  coil. 

THE  MACKENZIE-DAVIDSON  INTERRUPTER  (Figs.  11  and 
12)  is  the  sole  representative  of  the  rotary  metal  and  fluid  contact  interrupter 
on  the  market.  In  it,  a  small  motor,  fixed  in  a  slanting  position,  actions  the 
shaft,  the  metallic  blade  of  which  makes  and  breaks  contact  with  the  mercury. 
The  axial  rotation  of  the  shaft  thus  causes  the  interruptions.  The  speed  of 
the  motor  and  the  rate  of  interruption  are  controlled  by  a  miniature  rheostat. 
This  interrupter  is  simpler  in  construction  than  any  of  the  dipper  type,  and 
runs  more  quietly,  owing  to  the  absence  of  recijjrocating  motion:  but  the  ad- 
justment for  contact  duration  is  limited.  In  the  newer  model  the  position  of 
til*.  iiKjtur  has  been  altered.     W'lien  run  with  12  lo  20  volts  on  the  i)riniar>.  a 


12 


RADIO-THERAPY 


comparatively  small  number  of  sparks  are  elicited,  with  a  higher  speed  and  a 
suitable  resistance  in  the  circuit,  a  higher  E.M.F.  (up  to  lOO  volts)  can  be 
employed  without  breaking  down   the   coil.     Where   a   very  high  number  of 


Fig.   II.  Old  ]\Iackenzie-Davidsun  Interrupter.      (//.   ]]\  Cox,  Ltd.,  London.  > 


interruptions  must  be  obtained,  the  mercury  motor  breaks  of  this  type  yield 
place  to  the  rotary  interrupters. 

ROTARY  BREAKS. — In  this  class  of  interrupters,  the  separation  of 
the  contacts  is  effected  by  the  movement  of  a  revolving  disc  or  drum,  actioned 
by  an  electric  motor.  The  tendency  to  spark  at  break  is  diminished  by  sub- 
mersion of  the  contacts  and  drum  in  petroleum  or  alcohol.  The  two  chief 
types  of  this  break  are 

The  "Film"  Type  and  the  "Brush  Sector  Contact  Break."  The  Film 
type  consists  of  a  rotary  drum  fitted  with  copper  segments  (with  their  apices 
directed  downwards)  and  one  or  more  contact  brushes,  which  press  firmly 
against  its  curved  surface.  To  insure  perfect  electrical  contact  and  minimize 
friction,  a  film  of  mercury  (pumped  from  a  cell  in  the  bottom  of  the  jar) 
is  spread  between  the  two  contact  surfaces,  which  along  with  the  drum  are 


Fig.  12.  New  Mackenzie-Davidson  Interrupter.     (//.  W.  Cox,  Ltd.,  London.) 


immersed  in  parafiin  oil.  By  sliding  the  rod  bearing  the  brush  in  a  direction 
parallel  with  that  of  the  axis  of  the  drum  and  by  regulating  the  speed  of  the 
motor,  the  relative  period  of  contact  and  interruption,  as  well  as  its  frequency, 


NO  TES  OX  IXS  TR I  MEX  TA  TION  13 

can  be  altered  at  will.  Every  interrupter  of  this  type  which  is  actioned  by  a 
separate  motor  requires  to  be  started  before  the  current  is  switched  on  to  the 
primary  of  the  coil,  so  as  to  prevent  the  damage  that  the  rush  of  an  exces- 
sive, heavy  current  might  produce.  An  interrupter  of  this  class  is  shown  in 
Fig.  13- 

THE  BRUSH  SECTOR  CONTACT  BREAK.— In  all  types  of  this 
interrupter,  the  circuit  is  made  and  broken  by  two  contact  brushes  pressing 
against  a  segmented  revolving  copper  cylinder.  The  absence  of  mercury  and 
the  consequent  cleansing  it  entails  is  an  advantage.  It  is,  moreover,  perfectly 
silent  in  action.  Tliere  is.  however,  some  wear  on  the  brushes,  due  to  this 
steady  and  continuous  pressure  against  tlie  rotating  copper  sectors.  The 
drum  is  actioned  by  an  electric  motor.  The  circuit  remains  closed  as  long 
as  the  two  systems  of  brushes  press  against  the  same  segment  of  the  cylinder. 
The  rapidity  of  interruption,  which  varies  from  800  to   1,200  per  minute,   is 


Fig.   13.  The  "Pram"'  Break. 

controlled  in  part  by  regulating  the  speed  of  the  motor,  and  in  part  by  an 
adjustment  of  the  movable  brush. 

ELECTROLYTIC  INTERRUPTERS.— In  this  type  of  interrupters 
advantage  is  taken  of  the  interruptions,  caused  by  the  increase  of  current 
density  generating  sufficient  heat  to  vaporize  the  electrolytic  fluid  and  thus 
produce  an  insulating  sheath  about  the  surface  of  the  anode  or  at  the  aper- 
ture of  communication  between  the  inner  and  outer  jars  of  the  Caldzvcll  liquid 
interrupter.  The  two  chief  sub-groups,  into  which  this  class  is  subdivded  are 
(i)  The  Wehnelt  or  "Film,"  and  the  Simon-Caldzvell  or  "Liquid"  interrup- 
ters. 

The  "FILM"  type  (Fig.  14).  In  this  type  the  interruptions  are  caused 
by  the  formation  of  a  film  of  non-conducting  vapor  or  gas  about  the  active 
electrode,  which  is  the  anode.  As  the  break  in  the  circuit  is  instantaneous 
and  complete,  no  condenser  is  needed.  The  apparatus  has  been  said  to  work 
with  a  minimum  E.  M.  F.  of  16  to  24  volts ;  but  the  best  results  are  obtained 
with  a  current  of  50  to  120  volts.  The  number  of  interruptions  varies  with 
the  voltage  of  the  current  and  the  area  of  the  exposed  platinum  surface,  but  is 
always  very  high.  It  is  important,  therefore,  that  both  these  factors  should 
be  easily  controlled,  the  former  by  a  rheostat,  the  latter  by  varying  the  length 
and  sectional  area  of  the  platinum  dip  exposed.  As  the  ciTects  arc  in  a  meas- 
ure proportionate  to  the  size  of  the  wire  employed,  interrupters,  with  three  or 
more  wires  of  different  gauges,  arc  an  advantage.  With  a  voltage  of  40  to 
100  volts,  it  answers  admirably  for  short  runs,  but  if  used  continuously  for 


14 


RADIO-THERAFY 


half  an  hour  or  more,  the  acid  grows  hot  until  it  at  length  stops  the  working. 
To  diminish  fatigue  caused  by  the  excessive  generation  of  heat  in  the  elec- 
trolyte, a  leaden  pipe,  through  which  cold  water  is  kept  circulating,  sometimes 
forms  the  passive  electrode.  In  other  forms  of  this  apparatus,  the  container 
is  made  very  large.     Some  makers  seek  to  minimize  the  production  of  heat 


Fig. 


14.      Electrolytic    Film. 
&  Son,  London.  ) 


(  U'atsoii 


Fig.   15.  bullion  interrupter.     {Saiiitas 
Electrical    Co.,     London.) 


by  enclosing  the  break  in  a  large  container  through  which  cold  water  is  kept 
circulating.  The  substitution  of  the  sulphates  of  magnesia  and  of  potash 
alum  for  the  acidulated  solution  also  tends  to  retard  the  generation  of  heat. 
Interrupters  of  this  type  require  but  little  attention  and  are  easily  kept  in 
order,  but  the  loud  humming  noise  they  make  while  working  is  a  great  draw- 
back to  their  use. 

THE  LIQUID  ELECTROLYTIC  INTERRUPTER  (Fig.  15).— This 
was  simultaneous  and  independently  described  by  Dr.  Simon  and  Mr.  Cald- 
well, in  the  year  1899.  In  it  the  interruptions  are  brought  about  by  the  evap- 
oration of  the  electrolyte  at  the  aperture  connecting  the  two  chambers.  The 
frequency  of  interruption  is  proportionate  to  the  strength  of  the  current,  the 
size  of  the  aperture  and  to  some  extent  also  to  the  inductance  of  the  circuit. 
The  size  of  the  aperture  is  altered  by  the  movement  of  a  pointed  rod  of  non- 
conductive  material,  thus  allowing  some  control  to  be  exercised  over  the  fre- 
quency of  the  interruptions.  The  liability  of  the  inner  tube  to  be  damaged 
by  the  unequal  expansion  of  the  glass  of  which  it  was  made  led  to  the  sub- 
stitution for  it  of  perforated  porcelain  discs,  which  now  form  the  septum 
between  the  two  containers. 

The  very  considerable  heating  of  the  electrolyte  during  the  working 
of  the  break,  requires  some  of  the  various  methods  mentioned  in  dealing  with 
"Film"  Interrupters  to  be  adopted. 


XO  TES  ( )\  IXS  Tk  I  MEX  TA  Tl  OX 


15 


THE  JET  INTERRl'PrER. — In  tliis  interrupter  a  jet  of  mercury 
conveys  the  current,  while  a  revolving  drum  carrying  two  or  more  metallic 
segments  (according  to  the  voltage  of  current)  makes  the  circuit  by  inter- 
secting this  stream.  The  break  is  instantaneous  and  complete.  The  duration 
of  contact  can  be  varied  by  raising  or  lowering  the  contact  plate  relatively  to 
the  jet.  The  number  of  interruptions  is  easily  controlled  and  can  be  varied 
from  800  to  12.000  per  minute.  This  break  yields  a  thicker  spark  of  greater 
intensity  than  that  obtained  by  any  other  method.  It  is  silent  in  action,  and 
can  be  adapted  to  any  E.  AI.  F.  from  12  to  250  volts. 

A  small  rheostat  controls  the  speed  of  the  motor,  while  a  large  one  is 
usually  interposed  between  the  coil  and  the  mains.  This  is  the  only  interrupter 
that  automatically  switches  off  the  current  traversing  the  primary  circuit.  In 
the  H'odal  Interrupter  (Fig.  16),  the  mercury  pumped  from  the  reservoir 
is  forced  through  a  number  of  small  apertures  arranged  axially,  instead  of  a 
single  one.  The  contact-duration  is  varied  by  altering  their  number  bj'  means 
of  a  regulating  screw. 

APPARATUS  FOR  USE  WITH  ALTERNATING  CURRENTS.— 
To  obtain  a  pulsating  or  uni-directional  current  in  the  secondary  circuit  of  an 
Induction  Coil,  when  a  commercial  alternating  current  is  the  only  source  of 
energy  available,  it  is  advisable  to  adopt  one  of  the  following  expedients : 

(a)  Convert  the  alternating  current  into  a  continuous  current  by  means 
of  Mutor-Gcitcrators  or  Electrolytic  Rectifiers. 

(b)  Convert  the  alternating  current  into  an  iiitcnnittcnt  current  by 
suppressing  one  phase  by  means  of  an  Electrolytic  Break,  a  Synchronized 
Platinum  or  Rotary  Interrupter. 


//   ■'i/<'/    I  i'ii-nu|iUT.    {^luatas    l-.hclihul    (  ■-.,    Ldudon.) 


MOTOR  (;1-:NERAT0RS  (Fig.  17).— This  is  the  most  perfect  and 
economical  way  of  working  with  conuncrc:al  alternating  currents.  A  steady 
How  of  current  is  available,  and  the  arrangement  answers  admirably.  Its 
drawbacks  are  as  follows:  The  initial  cost  of  the  installation  is  great,  and 
the  introduction  of  machinery,  which,  unK"s  carefully  erected,  in  the  base- 
ment of  the  house  by  preference,  sets  up  vibratinn.  It  needs  to  be  started 
at  the  machine,  besides  requiring  a  certa-n  amount  ni  attention  for  regulation 
etc.      Motor    'J'niuxfnriiicrs,    lo   be    of   real    M-r\  ice.    ^IkiuIiI    b;tve    a    secondary 


i6 


RADIO-THERAFY 


output  of  not  less  than  300  watts.     A  rheostat  for  starting  and  controlling  the 
speed  of  the  alternating  motor  is  indispensable. 

ELECTROLYTIC  RECTIFERS.— The  principle  underlying  their  ac- 
tion is  the  great  resistance  (due  to  polarization)  that  the  current  has  to  en- 
counter when  the  aluminium  electrode  is  the  cathode.     In  its  simplest  form — 


Fig.  17.  Motor  Generator.    (Schall,  London.) 

the  Graetz  Aluminium  Carbon  Cell — the  aluminium  is  the  smaller  and  active 
electrode,  which  polarizes  rapidly  and  offers  a  high  resistance  to  the  passage 
of  the  current  when  it  is  the  cathode;  but  freely  allows  the  passage  of  the 
current  when  it  is  the  anode.  The  resistance  of  each  cell  is  calculated  to  be 
sufficient  to  stop  a  current  of  22  volts  from  passing.  Its  efficiency  is  about 
35  per  cent,  less  than  that  of  the  supply  circuit.  The  cells  in  working  grow 
hot,  and  when  a  certain  temperature  is  reached  polarization  ceases.  Special 
precautions  have,  therefore,  to  be  taken  to  prevent  this.  The  cells  are  some- 
times placed  in  a  zinc  container,  through  which  a  stream  of  cold  water  is  kept 
circulating;  but  the  use  of  hollow  lead  pipes  (with  cold  water  circulation)  as 
the  large  passive  electrode  is  to  be  preferred.  A  form  of  electrolytic  rectifier, 
which  of  late  years  has  attracted  much  attention,  both  on  account  of  the  sim- 
plicity of  its  construction  and  its  high  efficiency,  is  the  Nodon  Valve  (Fig.  18). 
In  it,  the  active  electrode  is  a  slender  rod,  made  of  an  alloy  of  aluminium  and 
zinc ;  while  the  passive  electrode  is  the  iron  container.  The  electrolyte  is  a 
solution  of  phosphate  of  aluminium,  which  is  deposited  as  a  thin  film  upon 
the  active  electrode,  when  it  is  the  cathode.  This  is  sufficient  to  prevent  the 
passage  of  any  current  below  22  volts  in  this  direction.  When  the  aluminium 
is  the  anode,  the  current  flows  freely.  The  cells  heat  up  slowly  when  working. 
When  they  have  been  lying  idle  for  some  time,  a  small  resistance  between  them 
and  the  mains  is  needed  to  start  polarization.  The  number  of  cells  (connected 
in  series)  which  should  be  inserted  into  the  primary  circuit  depends  on  the 
voltage  employed.     The  chief  advantages  of  electrolytic  rectifiers  are : 

(a)  Complete  independence  of  the  periodicity  of  the  commercial   cur- 
rent, or  of  any  change  in  the  same. 

(b)  The  entire  absence  of  all  noise  and  motion. 

(c)  The  small  amount  of  attention  required. 

(d)  Their  high  efficiency  (65%)  and  low  cost  as  compared  with  motor 
generators. 


NOTES  OX  IXSTRUMENTATION 


17 


Sometimes  the  starting-up  process  is  unduly  prolonged  or  quite  impos- 
sible. This  shows  that  the  cells  require  to  be  cleaned.  Apart  from  the  heat 
engendered  by  fatigue  is  that  due  to  defects  in  the  aluminium  alloy,  the 
boiling  over  so  caused  being  often  productive  of  a  short  circuit. 

ELECTROLYTIC  BRE.\KS.— Both  the  "Film"  and  "Liquid"  types 
are  available  for  use  on  alternating  mains.  They  act  by  suppressing  one 
phase  of  the  current.  In  the  WEHNELT  type,  the  current  only  passes  when 
the  platinum  is  the  anode.  The  chief  objection  to  their  use  with  alternating 
currents  is  a  great  waste  of  platinum.  They  are  also  very  liable  to  fatigue 
with  prolonged  working.  The  current  is,  moreover,  but  imperfectly  converted 
into  a  uni-directional  one,  unless  the  primary  of  the  coil  is  specially  wound  to 
allow  of  a  variation  of  its  self-induction.  When  the  CALDWELL  type  is 
used,  the  smaller  lead  electrode  is  replaced  by  one  made  of  aluminium;  but 
even  then  it  is,  at  its  best,  only  a  poor  substitute  for  the  more  efficient  elec- 
trolytic rectifiers,   which   it  seeks  to   replace. 

In  the  SYNCHRONIZED  PLATINUM  BREAK  the  vibration  of  a 
bar-magnet,  whose  movements  are  synchronized  with  one  phase  of  the  com- 
mercial current,  gives  rise  to  the  interruptions.  The  objections  to  its  use  are 
that  it  not  only  wastes  one  phase  of  the  current,  but  also  is  only  available  for 
use  with  coils  of  small  or  medium  size.     It  is,  besides,  rather  noisy,  requires 


Fk;. 


Rectifier.    (Isciitlial.    London.) 


much   delicate  adjustment  and   frc-quent  attention,  as  well  as  presenting  all 
the  other  disadvantages  of  the  ordinary  platinum  interrupter. 

The  idea  underlying  the  construction  of  THE  SYNCHRONIZED 
ROTARY  BRK.XK  CFigs.  19  and  20),  is  to  interrupt  the  current  once  in 
either  phase  and  at  the  moment  of  maximum  intensity.     As  the  circuit  is  open 


i8 


RADIO-THERAPY 


for  one  phase  only  of  the  current,  the  flow  is  intermittent.  The  rapidity  of  the 
interruptions  is  determined  by  the  periodicity  of  the  main  and  is  capable  of  no 
variation.  The  conditions  under  which  these  interrupters  attain  their  maxi- 
mum of  efficiency  is  where  the  interrupter-spindle  and  that  of  the  synchroniz- 
ing motor  are  finnly  coupled  together  without  any  elastic  or  slipping  couplings. 
Jet  Interrupters  and  Turbinia  Breaks,  when  so  coupled  together,  give  the  best 
results.  The  motor  has  to  be  started  by  a  flywheel  driven  by  hand-power  until 
the  correct  speed  is  arrived  at.  It  has  further  to  be  adapted  to  the  dynamo 
which  feeds  it.  If  the  dynamo  runs  smooth  and  maintains  a  constant  fre- 
quency, the  results  are  excellent;  but  this  cannot  always  be  secured.  Another 
objection  to  its  use  is  its  great  cost. 


Fig.  19.   Synchronized  Turbine  Interrupter.    (Saiiitas  lilcctrical  Co.,  London.) 

STATIC  MACHINES  (Figs.  21,  22  and  23)  are  the  only  direct 
source  of  uni-directional  currents  of  high  potential  and  small  amperage,  like 
that  required  to  operate  a  focus  tube ;  and  as  such  is  better  fitted  for  this  pur- 
pose than  to  charge  the  condensers  of  a  High  Frequency  Apparatus.  .W- 
though  generally  said  to  derive  its  efticiency  from  Frictional  Electricity,  this 
popular  belief  is  a  very  imperfect  statement  of  the  truth — at  least  in  the  case 
of  modern  Influence  Machines,  which  derive  the  major  part  of  their  charge 
from  Electro-Static  Induction.  For  the  subtle  influence,  which  one  electrified 
body  has  on  all  other  conductors  brought  into  proximity  with   it,  has  more 


XOTES  OX  IXSTRi'MEXTATIOX 


19 


to  do  with  their  etiiciency  than  tlio  energy  derived  from  friction.  The  three 
principal  tvpes  of  Influence  Machines  in  common  use  are  the  HOLTZ.  the 
VOSS.  and  the  WLMSHL'RST. 

In  the  JVintslmrst  machine,  both  the  circular  discs,  which  are  about 
J4  inch  apart,  are  made  to  revolve  in  opposite  directions;  in  the  Holtz  ma- 
chine, on  the  other  hand,  one  plate — the  larger — is  permanently  fixed,  and  has 
the  other  revolving  much  closer  to  it.  In  the  earlier  models  the  revolving 
plates  were  made  of  glass,  whose  liability  to  break  when  made  to  revolve  at  a 
high  speed  is  so  great  that  a  sufficient  supply  of  current,  steady  and  ample 
enough  for  all  purposes,  could  only  be  attained  by  the  costly  multiplication 
of  gigantic  plates,  whose  very  size  increased  their  liability  to  fracture.  The 
substitution  of  ebonite  and  compressed  mica  plates  is  an  improvement  in  the 
right  direction,  as  the  increase  in  speed  makes  up  for  the  diminished  surface- 


Fk;. 


.Synchriin;zed    Turbine    Interrupter.       {Jscntlial,    London.) 


capacity  of  the  discs.  The  saving  in  floor  space  thus  obtained  is  an  important 
consideration.     The  chief  types  of  irinishiirst  machines  upon  the  market  are: 

(i)    Machines  with  multi-sector  plates  and  simple  brushes. 

{2)  Machines  with  multiple  brushes  and  no  sector,  and  machines  of 
the  mixed  type,  which  combine  the  advantages  of  both  systems — auto-excita- 
tion, with  increased  output.  The  only  jjorialile  machine  of  the  ll'imsliurst 
type  with  which  I  am  ac(|uainted  is  that  manufactured  by  .1/.  Ih-ault,  of  Paris, 
and  described  by  Dr.  Bcelere  in  the  "Archives  d'electricite  medicale"  (July 
15th,  1900).  It  was  especially  iiitendcd  for  radiographic  work,  weighs  only 
32  kilos,  and  packs  away  along  with  rill  accessories  into  a  case  measuring 
82  by  87  by  53  cm. 

ADVANTAGES  AND  DISADVANTAGES  OF  THE  STATIC  MA- 
CHINE.— The  simplicity  of  its  construction,  the  absence  of  delicate  and  com- 
plicated apparatus,  the  independence  of  the  operator  of  local  contingencies  and 


20  RADIO-THERAPY 

circumstances,  the  minimum  of  attention  required  to  maintain  it  in  good 
working  order,  and  the  almost  perfectly  continuous  current  it  produces  are 
among  its  chief  advantages.  The  low  amperage,  which  unfits  it  to  charge  the 
condensers  of  a  High  Frequency  machine,  the  liability  of  its  surface  to  ac- 


FiG.  21.     Static  Film  Machine. 


cumulate  damp,  and  of  the  metallic  sectors  to  oxidation,  the  erratic  reversal 
in  its  polarity  (especially  when  used  for  radiography),  and  its  liability  to 
electrical  leakage  and  set  up  brush  discharges,  coupled  with  its  large  size  and 
high  initial  cost,  are  among  its  chief  disadvantages.  It  is  better  fitted  for 
fluoroscopic  examination  than  for  radiographic  work,  the  most  probable  rea- 
son being  that  a  high  potential  difference  in  the  electrical  charges  on  its 
armatures  is  more  easily  maintained  with  a  high  resistance  focus  tube  in  the 
circuit  than  by  the  use  of  one  of  lower  vacuum-resistance.  To  obviate  the 
difficulty  of  using  low-resistance  tubes,  Drs.  IVilliains  and  Rollins  have  in- 
troduced into  the  circuit  between  one  or  other  of  the  terminals  of  the  tube 
and  the  positive  or  negative  leads,  a  multiple  spark-gap — a  device  which  al- 
lows the  radiation  of  the  tube  to  be  very  largely  modified  so  as  to  give  hard 
or  soft  screenic  effects.  Before  attaching  the  leads  to  the  terminals  of  the 
tube,  the  polarity  of  the  current  should  be  ascertained  by  watching  the  charac- 
ter of  the  sparks  that  pass  between  the  knobs  of  the  dischargers ;  these  con- 
verge to  a  point  at  the  positive,  and  spread  themselves  over  a  wider  area 
at  the  negative  pole. 


XOTES  OX  IXSTRi'MUXTATlOX 


21 


APPARATUS    EMPLOYED    IX    VIBRATORY    ELECTRISATION. 

In  noticing  the  apparatus  used  in  the  treatment  of  diseases  by  currents 
of  high  frequency,  we  can  for  purposes  of  classificaticm  divide  them  into  four 
chief  groups : 

{a)   Apparatus  employed   in  generating  ihc   oscillatory   currents. 

{b)  Apparatus  employed  in  raising  the  tension  of  the  currents  of  high 
frequency. 

{c)  Apparatus  whose  use  is  peculiar  to  the  individual  methods  of 
application. 

(</)   Instruments  for  measuring  the  amperage  of  the  currents,  etc. 

(a)  APPARATUS  EMPLOYED  IN  GENERATING  THE  OSCIL- 
LATORY CURRENTS. —  Although  Tcsia  has.  by  running  an  alternator 
with  384  poles  at  a  very  high  speed  (3.000  revolutions  per  minute),  been  able 
to  obtain  a  current  with  a  frequency  of  10.000  periods  per  second,  this  mechan- 
ical process  has  not  been  generally  adopted  ;  the  oscillatory  discharge  of  con- 
densers, on  the  contrary,  is  the  method  most  commonly  employed.  The 
period  of  vibration  of  the  currents  so  obtained  is  measured  by  hundred-mil- 
lionths  of  a  second.  The  number  and  arrangement  of  the  condensers  vary 
somewhat  in  different  types  of  apparatus,  but  the  principle  underlying  their 
application  is  the  same  in  all. 

In  the  Carre  &   Tcsla   Traiisforiitcrs  only  one  condenser  is  employed. 


Fig.  22.     Iligh-Spced   Sectorless  Static   Machine*. 


Its  armatures  are  connected  with  the  secondary  terminals  of  a  high  intensity 
spark-coil  on  the  one  hand,  and  with  the  discharging  pillars  of  an  adjustable 
spark-gap  on  the  other;  while  the  solenoid  of  high  frequency,  which  consists 
of  12  to  20  turns  of  stout  copper  wire,  forms  part  of  the  circuit  of  discharge 


22 


RADIO-THERAPY 


between  the  external  armature  and  the  pillar  of  the  spark-gap  with  which  it 
is   connected. 

The  Texeira  Transformer  (Fig.  24)  is  in  many  respects  the  same,  with 
the  exception  that  in  it  a  battery  of  Leyden  jars  (2  to  4  in  number  and  con- 
nected in  series)  is  substituted  for  the  single  condenser  of  which  both  Carre 
and  Tcsla  make  use. 

In  the  D'Arsonval  Transformer  (Fig.  25),  and  all  modifications  of  this 
apparatus,  two  condensers  are  emploj'ed.  The  internal  armature  of  each  is 
connected  with  one  of  the  secondary  terminals  of  the  induction  coil  and  with 
the   discharging  pillars   of   the   spark-gap;    while   the  externa!   armatures   are 


Fig.  2^.     Static  Machine.      (Smith  <'jr  Wade.  London. 


united  by  the  small  solenoid  of  high  frequency  formed  of  15  to  20  spirals  of 
thick  copper  wire. 

The  apparatus  of  O'farril  &  Lebailly  (Fig.  26)  is  a  modification  of  the 
D'Arsonval  Transformer  in  wh.ich  the  solenoid  of  high  frequency  is  re- 
placed by  a  duplex  resonator,  with  which  the  external  armatures  are  con- 
nected. 

An  apparatus  somewhat  similar  is  the  Rochefort  model  (Fig.  27),  for 
use  with  two  condensers.  In  it  similar  bipolar  effects  are  obtained  by  the  use 
of  two  ordinary  resonators,  the  free  extremities  of  their  lowest  spirals  being 
directly  connected  with  one  another. 


NOTES  OX  IXSTRL'MEXTATION 


23 


The  apparatus,  however,  which  .1/.  Roclict'ort  most  strongly  recom- 
mends is  that  represented  in  Fig.  28.  Here  four  condensers,  divided  into 
two  batteries,  are  employed.  The  internal  armatures  of  these  are  connected 
with  the  terminals  of  the  secondary  of  his  transformer,  which  serves  all  the 


4:e-f;i 


<>=<^ 


WWR) 


The  D'.lrsoiii'al   Transformer. 


purposes  of  a  spark-coil,  but  with  greater  efficiency.  The  external  armatures 
are  connected  with  the  two  resonator-,  after  the  manner  shown  in  Fig.  27; 
the  use  of  the  small  solenoid  of  high  frequency  is  entirely  dispensed  with. 

In  all   these   transformers   the  capacity  of  the  condensers   employed   is 
proportioned  to  the  self-induction  and  resistance  of  the  circuit,  so  as  to'main- 


C^) 


Fig.    26.     Apparatus    of    O'Farril    & 
Lcbaillv. 


lM(i.  27.  Roche  fort's  Model   for 
L'se  with  Two  Condensers. 


tain   the  oscillatory   ciiaracter  of  the   >i)ark  discharges,   which  ar(.'  the  source 
of  the  alternating  currents  of  liigh   fre(|uency. 

As  the  n'Arsom'al  type  oi  api)aratus  is  by   far  the  most  generally  em- 
ployed, we  can   with  advantage  -tudy  its  various  parts  in  fuller  detail. 


24 


RADIO-THERAPY 


CONDENSERS. — There  are  two  types  of  conderibers  used  by  different 
makers  in  the  construction  of  this  transformer.  The  one  is  the  Leyden  jar, 
the  other  the  plate  condenser.  The  former  are  chiefly  employed  by  instrument 
makers  both  in  Germany  and  England ;  the  use  of  the  latter  is  at  present 
confined  to  France.  The  chief  advantage  claimed  for  the  plate-condenser 
is  that  the  dielectric  can  be  more  easily  obtained  of  a  uniform  thickness,  so 
that  no  undue  electrical  stress  is  brought  to  bear  on  any  point  of  its  coated 
svirface.  This  lessens  the  liability  of  the  glass  to  be  pierced  by  a  disruptive 
discharge  passing  between  its  two  coats.  By  submersion  in  a  bath  of  high- 
flash  petroleum  oil,  these  plate-condensers  are  rendered  less  liable  to  become 
oxydised,  and  so  preserve  their  coats  intact  for  longer  periods  than  Leyden 
jars,  which  are  not  insulated  in  the  same  way.  On  the  other  hand,  it  has  to  be 
noticed  that  the  inductive  influence  of  the  charge  imparted  to  the  internal 
armature  of  the  Leyden  jars  is  increased  by  their  configuration,  while  at  the 
same  time  the  capacity  of  the  jars  can  be  more  readily  varied  so  as  to  alter 
the  frequency  of  the  oscillatory  discharges  passing  between  the  discharging 
balls  of  the  spark-gap. 


Fig.  28.  Rochefort's  Model 
for  Use  with  Four  Con- 
densers. 


Fig.  29.    High-Frequency  Apparatus, 
with  Square  Spark-Box. 


The  Detonator  or  Spark-box  (Fig.  29).^ — This  useful  accessory  has 
been  given  various  shapes  by  different  makers,  who  have  endeavored  by 
various  expedients  to  correct  the  several  drawbacks  attending  its  use.  The 
passage  of  an  oscillatory  discharge  between  the  knobs  of  the  discharger  gives 
rise  to  a  loud  reverberating  cackling  noise,  which  is  nowise  conducive  to 
quieting  the  alarm  of  nervous  patients.  In  the  attempt  to  muffle  the 
sound  by  enclosing  the  discharging  knobs  in  a  glass  or  earthenware  spark- 
box,  it  was  noticed  that  nitrous  compounds  were  generated,  which,  by  uniting 
with  the  moisture  of  the  enclosed  air,  formed  nitric  acid.  The  deposit  of  this 
conducting  fluid  on  the  inner  sttrface  of  the  detonator  increased  the  tendency 


NOTES  OX  IXSTRl'MEXTATION 


25 


to  arcing.  In  its  simplest  form  the  spark-box  consists  of  a  cubical  earthenware 
or  glass  box  with  vulcanite  lid.  As  this  does  not  entirely  suppress  the  dis- 
agreeable sounds,  it  was  considered  advisable  to  further  enclose  it  in  a  felt- 
lined  wooden  box,  which,  on  account  of  its  efificiency,  is  well  named  the 
silent  spark-box.     It  figures  in  the  apparatus  shown  in  Fig.  30.     As  the  fre- 


r /^//iMIIf If f If  f  if  «i««f  f  llf  P  Kitf  f  If  II^^HllMf  If 


///i iinijiiiiijfnnjiijiij^^j^ ilU'lifiiiiUHil I ! ! ! f ! j *;'ki-  - 
iMviliiiB/i/niffiniiiliunuMHifiiniitiiliiiii^ 

""j! ,1    ,  .'m    ,.i, ,      ,.,  i  ~ 

^|MltMMMMI!lllltll|||{^|Jjj||llll>C<l«l|l|ll!l||||| 

IU\\m\u\\u%\muiiiiiiiipii|iiiiiiiiMiuiiiiiifiiiiii 


«isiiiiiiiiia 


Fig.  30.  New 


Alodel    H.  F.    Apparatus,    with    Rotary    Solenoid    and    Silent 
Spark-Box.     (Isenthalj  London.) 


quency  of  oscillation  of  the  alternating  discharge  depends  upon  the  resistance 
of  the  air-gap  between  the  knobs  of  the  discharger,  it  was  considered  advis- 
able to  enclose  it  in  a  transparent  cylindrical  glass  tube,  fitted  with  vulcanite 
(felt-lined)  caps,  as  in  Fig.  31,  through  which  the  distance  between  the  balls 
could  be  accurately  gauged  without  opening  the  lid  of  the  spark-box ;  but  as 
the  same  object  can  be  more  accurately  effected  by  means  of  the  graduated 


Klliii'iiii'" ""!!f|jj||''f"V''V''''''"^^^^^ 

^sl'lw::::::!::::::::::;!!!!!]!::;: 


?J^,,=:ri,^; 


II        III 


Fig.  31.    11.   1''.  .ApiKuatus.     (IValson  &  Sons,  London.) 


sliding-rod  of  the  Silent  Spark-Box  there  is  no  real  advantage  to  be  gained  by 
the  use  of  glass.  The  liability  of  the  spark  discharge  to  arc  and  so  destroy  the 
box  has  been  met  by  the  use  of  a  magnalium  detonator,  which  effectually 
prevents  the  deposit  of  moisture  upon  these  surfaces.  The  movable  arm  of 
the    detonator    is,    in    the    apparatus    of    some    makers,    spirally   grooved    or 


26 


RADIO-THERAPY 


threaded,  to  prevent  any  unintentional  alteration  of  the  distance  between  the 
knobs  of  the  discharger,  and  to  allow  a  tiner  graduation  in  its  adjustment. 

The  Small  Solenoid  of  High  Frequency,  so  named  from  its  intimate 
association  with  the  armatures  of  the  condensers,  consists  of  12  to  20  turns  of 
coarse  copper  or  mangano-copper  wire,  connected  through  the  supporting 
pillars  with  the  external  coats  of  the  condensers.  As  the  amount  of  current 
passing  into  the  body  of  the  patient  in  the  bipolar  method  of  direct  applica- 


FiG.  32.    Contact  Rod  Regulator. 


tion  and  also  in  bipolar  condensation  depends  on  the  self-induction  of  this 
circuit,  the  method  employed  to  vary  the  number  of  spiral  turns  introduced 
into  it  is  a  matter  of  paramount  importance.  The  five  chief  methods  of 
control  are  as  follows  : 

The  Sliding  Contact  Rod  Regulator  (Fig.  32). — This  consists  of  a 
metallic  rod  permanently  connected  with  one  end  of  the  small  solenoid  and 
fitted  with  an  insulating  handle      By  sliding  along  a  groove  in  the  supporting 


Fig.  ^^:^.    Movable  Contact- Point  Regulator. 


Fig.  34.    Adjustable   Spring  Catch. 


pillar  it  can  touch  any  desired  spiral,  and  by  so  doing  throw  out  of  the  circuit 
one  or  more  turns  of  the  solenoid.  In  some  models  it  passes  into  the  in- 
terior of  the  solenoid;  in  others  it  touches  the  spirals  externally.  The  tension 
of  the  current  in  the  shunt  circuit  diminishes  as  the  rod  is  pushed  home,  and 
increases  as  it  is  withdrawn.  The  brass  tube-regulator  that  works  in  the 
interior  of  the  solenoid  of  the  Carre  Transformer  is  a  variation  of  this  method 
of  control.     This  arrangement  allows  a   certain  measure   of  general   control, 


XOTES  OX  IXSTRL'MEXTATIOX 


27 


Out    no   finer   adjustnicnt ;   besides   this,    the    rod,    when    fully    witlulrawn,    is 
liable  to  get  in  the  way  of  the  operator. 

The  Moz'abic  Contact-Point  Regulator  (Fig.  2>3)- — 1^"  this  method  the 
Hiovable  contact-point  slides  along  a  metallic  conducting  rod  (directly  con- 
nected with  one  of  the  supporting  pillars  of  the  solenoid,  but  insulated  from 
the  other,  which  also  helps  to  support  it).  The  free  extremity,  by  touching 
the  wire  of  the  solenoid,  can  establish  contact  with  any  desired  spiral.  This 
allows  of  an  irregular  and  somewhat  coarse  graduation  of  the  intensity  of  the 
current,  without  any  marked  interruption  of  its  flux,  provided  the  contact 
piece  be  broad  enough  to  touch  two  adjacent  spirals. 

The  Storing  Catch  (Fig.  34). — This,  the  oldest  and  most  crude  method 
of  control,  is  in  every  way  objectionable.  Every  time  the  catch  is  removed 
for  readjustment  an  interruption  in  the  current  is  produced.  An  attempt  has 
been  made  to  remedy  this  by  connecting  the  spring-catch  with  one  extremity 
of  the  solenoid.  Although  in  this  case  the  flow  of  the  current  is  never  inter- 
rupted, still  the  removal  of  the  catch  from  a  spiral  immediately  throws  into 
the  direct  circuit  every  turn  of  the  solenoid,  and  as  suddenly  increases  the 
intensity  of  the  current  in  the  derived  circuit. 

The  Rcz'ok'ing  Solenoid. — In  this  form  of  control  the  wire  solenoid 
is  wound  about  an  insulating  wooden  or  ebonite  cylinder,  its  terminals  being 
attached  to  the  two  cheek-plates  which  serve  as  the  axil  of  the  cylinder. 
The  rotations  of  the  cvlinder  brine;  the  convolutions  of  the  wire  in   contact 


Fig.  .35.     Rotary  Contact  Piece. 


with  the  sliding  contact-point  and  allow  of  complete  control  over  the  intensity 
of  the  current  passing  into  the  derived  circuit. 

The  Rotary  Contact  Piece  (Fig.  35). — This  type  of  control  is  the 
counterpart  of  that  last  mentioned.  In  it  the  rotation  of  a  grooved  central 
rod  is  made  to  convey  its  motion  to  the  sliding  contact  wheel,  which  follows 
the  gyrations  of  the  spirals  while  maintaining  perfect  contact  with  them. 
As  the  capacity  of  the  wire  employed  in  forming  this  solenoid  is  greater 
than  that  used  on  the  diminutive  revolving  solenoid,  a  finer  graduation  of  con- 
trol can  thus  be  produced,  for  both  capacity  and  self-induction  influence 
resonance,  aufl  by  so  doing  the  intensity  f)f  the  current  i)assing  into  the  ^hunt 
circuit  formed  by  connection  with  the  terminals  of  a  resonator  (hidin. 

Of  thc-e  five  regulations,  the  revolving  solenoid  and  rotary  contact 
piece  are  the  best  form  of  apparatus,  as  with  them  the  flux  of  tlu'  current  is 
never  interrujjted  and  the  gradualiin   very   delicate  and   fine. 

The  inten-ity  of  the  current  iii  the  (K'rivrd  circuit  is  hot  nuMsured 
bv  the  moving  coil   millianuneter. 

(h)  APPARATUS  FMPLOVEl)  IX  R.M.Sl.XCi  THE  TENSION 
OF  THE   CL'RRFXT. — .As   there  are   limes   wlun    it    is   advantageous  to   in- 


28 


RADIO-THERAPY 


crease  the  tension  of  the  currents  employed  in  vibratory  electrisation,  several 
different  kinds  of  apparatus  have  been  constructed  for  the  purpose.  The 
chief  of  these  are : 

(i)   The  Tesla  Coil. 

(2)  The  Oudin  Resonator. 

(3)  The  D'Arsonval  Bipolar  Coil  of  High  Tension. 

(4)  The  Spirals  of  Guilleminot. 

(5)  The  Cones  of  Reus. 

(i)   The  Tesla  Coil,  the  first  in  order  of  time  of  the  apparatus  devised 
for  raising  the  tension  of  the  current,  was  invented  by  Tesla  in  the  year  1891. 


Fig.  36.     The  Tesla  Coil.      (Leslie  Millei,  London.) 


It  essentially  consists  of  an  inner  and  an  outer  coil,  with  the  former  of 
which  a  condenser  and  spark-gap  are  connected  in  series.  Both  coils  and 
the  condenser  are  usually  submerged  in  an  insulating  container  filled  with 
oil.     The  primary  or  inner  coil  consists  of  a  few  turns  of  stout  copper  wire, 


NOTES  OX  IXSTRUMENTATIOX  29 

\vhile  the  secondary  or  outer  is  a  single  layer  of  many  turns  of  fine  copper 
wire,  wound  round  the  primary,  from  which  it  is  carefully  insulated.  The 
apparatus  can  be  fed  by  either  a  spark-coil  or  step-up  transformer.  It 
yields  a  plentiful  supply  of  sparks  of  any  desired  length,  but  the  noise  made 
when  working  is  deafening. 

(2)  The  Oudin  Resonator. — Although  Hertz  had  previously  employed 
the  phenomena  of  resonance  in  his  experiments,  it  is  to  Dr.  Oudin  that  the 
resonator  owes  its  introduction  into  electrotherapeutics.  He  first,  in  1S92, 
made  use  of  resonance  effects  to  elevate  the  tension  of  currents  of  high 
frequency.  The  apparatus  devised  by  him  consists  of  a  large  solenoid  of 
uninsulated  copper  wire,  of  medium  thickness,  wound  spirally  about  a  ver- 
tical cylinder  of  well-parafifined  wood.  The  total  length  of  the  wire  em- 
ployed varies  from  45  to  60  metres,  and  its  diameter  from  2.5  to  3  millimetres. 
It  makes  50  or  more  turns  about  a  wooden  cylinder  40  to  50  centimetres  in 
height  and  30  centimetres  in  diameter;  while  the  distance  between  the  spirals 
is  about  8  millimetres. 

As  forced  resonance  is  more  powerful  in  its  effects  than  free  resonance, 
the  resonator  was  at  first  attached  to  one  pole  of  the  solenoid  of  high  fre- 
quency ;  the  other  pole  remained  free  or  was  connected  to  earth.  This 
arrangement,  however,  was  soon  modified.  It  was  found  that  better  effects 
could  be  produced  by  connecting  both  poles  with  the  resonator.  A  subse- 
quent modification  led  to  the  solenoid  of  high  frequency  being  suppressed 
and  the  resonator  directly  connected  with  the  external  armatures  of  the  con- 
densers. The  lowest  spiral  of  the  resonator  was  then  united  to  one  arma- 
ture, while  a  spiral  four  to  seven  turns  above  it  was  connected  with  the 
other  armature  by  an  adjustable  clip.  The  resonator  was  thus  divided  into 
two  solenoids — a  lower  and  an  upper.  The  lower,  or  primary,  solenoid,  of 
small  size,  consisted  of  the  few  turns  of  wire  intercepted  between  the  points 
of  attachment  of  the  two  cords  leading  to  the  external  armatures.  In  it 
circulated  currents  of  both  high  and  medium  frequency,  those  of  high  fre- 
quency alone  being  free  to  pass  into  the  tipper  solenoid ;  for  the  currents  of 
lower  frequency  were  close-circuited  by  it.  The  secondary  or  upper  solenoid 
was  longer,  and  was  traversed  by  currents  of  high  frequency  alone ;  these, 
by  reason  of  the  self-induction  ot  the  circuit,  attained  an  enormous  tension. 
When  the  three  essential  magnitudes — capacity,  self-induction  and  resistance — 
of  the  two  solenoids  were  by  trial  proportioned  to  one  another,  the  upper 
spirals  of  the  resonator  and  its  free  terminal  were  seen  bathed  in  a  lively 
brush  discharge,  like  to  that  produced  by  a  Tesla  coil  or  influence  machine. 
This  efiluve  is  made  use  of  for  therapeutical  purposes,  by  connecting  the 
free  terminal  of  the  resonator  or  one  of  its  upper  spirals  with  the  wire  lead- 
ing to  the  electrode. 

Although  the  calibre  of  the  wire,  which  forms  the  resonator,  does 
not  appear  to  materially  interfere  with  the  production  of  these  resonance 
effects,  yet  it  has,  according  to  Oudin,  a  considerable  influence  on  the  physical 
character  of  the  elTluve  and  spark.  A  fine  wire  yields  a  spark,  long,  thin, 
sinuous  and  scarcely  painful,  with  an  efiluve  as  poorly  nourished;  while  with 
a  wire  of  larger  dimensions,  both  effluvc  and  spark  gain  in  force.  This 
depends  on  the  capacity  of  the  wire  rather  than  its  self-induction,  for  every  in- 
crease of  capacity  renders  the  spark  more  vigorous  and  painful. 

The  manner  in  which  connection  was  established  between  the  poles  of 
the  primary  solenoid  of  the  resonator  and  the  external  armatures  of  the 
condensers  next  attracted  attention.  It  was  recognised  that  the  nature  of  the 
arrangement  that  exists  for  this  purpose  largely  influenced  the  adjustment 
of  the  two  solenoids  and  the  regulation  of  the  effects  produced.  The  crude 
and  unsatisfactory  method,  in  which  a  spring-clip  or  contact-hook  is  used  to 
connect  the  wire  from  the  external  armature  with  the  desired  spiral  soon  gave 
place  to  others  which  allowed  more  perfect  reg:ulation  and  adjustment  to  be 
made  without  in  any  way  interrupting  tlie  circuit.  Ducretet  and  Bonnctti  in- 
vented an  apparatus  in  which  a  grooved  contact-slip  is  made  to  revolve  about  a 
fixed  resonator,  and  thus  establish  contact  with  the  spirals;  while  Radig,nei 
caused  the  resonator  itself  to  rotate  before  a  stationary  contact-point.  Both 
these  methods  allow  of  a   more  perfect   graduation   of  effects   and   an   easier 


30 


RADIO-THERAPY 


adjustment  of  the  solenoids  to  each  other,  without  any  interruption  of 
contact. 

The  resonators  above  described,  however,  are  only  suitable  for  pro- 
ducing unipolar  efifects.  If  double  effluvation  is  to  be  practised,  the  appa- 
ratus of  Lcbailly  &  O'Farril  or  that  of  M.  Rochcfovt  must  be  resorted  to. 

In  the  former  the  primary  solenoid  is  centrally  situated,  the  external 
armatures  being  connected  with  two  intermediate  spirals.  This  creates  two 
secondary  solenoids,  which  are  situated  one  on  either  side  of  the  primary, 
and  allows  of  bipolar  applications  to  be  made  by  connecting  the  wires  leading 
to  the  electrodes  with  the  free  outer  terminals  of  these  two  solenoids. 

Although  the  apparatus  is  an  improvement  on  the  unipolar  resonator 
of  Oiidin.  still  it  is  not  ahvays  easy  to  equalise  the  current  density  at  the  two 
poles,  and  for  this  reason  that  of  M.  Rochcfort  is  to  be  preferred. 

In  the  Rochcfort  model  {vide  Fig.  28)  four  Leyden  jars  are  employed. 
These  are  divided  into  two  batteries,  connected  by  their  internal  armatures 
with  the  secondary  terminal  of  an  induction  transformer  or  spark-coil.  The 
external  armatures  are  connected  with  two  separate  resonators,  those  of  each 
battery  being  connected,  the  one  with  the  lower  terminal  of  one  resonator, 
the  other  with  the  uppermost  spiral  of  the  primary  solenoid  of  the  other 
resonator.  When  carefully  adjusted,  the  density  of  the  current  traversing 
each   of   the   secondary   solenoids   is   equalised;    and   being   of   opposite   sign, 


Fig.  37.     Double    Mode!    Resonate 


{Dean.    London.) 

produced   readily 


double   effluvation    can    easily    be    practiced    and    the    effect 
cfjutrolled. 

The  position  of  the  resonator  in  the  apparatus  of  different  makers  calls 
for  a  few  remarks.  In  some  apparatus,  as  in  Fig.  3/,  the  solenoid  stands 
upright  on  the  cabinet  enclosing  the  condensers  and  spark-gap;  in  others,  as 
'"  Fig-  .38.  it  is  permanently  connected  with  the  condensers;  in  others,  again. 


NOTES  OX  IXSTRi'MEXTATlON 


31 


the  resonator  is  horizontally  placed  so  as  to  allow  its  inclusion  in  a  cabinet ; 
and  lastly,  it  may  be  inverted  and  fixed  by  its  base  to  the  bottom  of  the  base- 
board of  the  high  frequency  table,  as  in  Fig.  39.  As  there  is  no  special 
advantage  gained  by  any  of  these  peculiar  arrangements  beyond  the  mere 
matter  of  saving  space,  these  eccentricities  call  only  for  a  passing  notice. 
}kluch   more   important,    however,    is   the   arrangement    for  graduation.     The 


Fxci.  38.    Single  Alodcl  Resonator.      (Dcaii,  London.) 


crude  method  of  regulation  by  the  contact  clip  must  only  be  mentioned  to  be 
condemned.  The  regulation  by  means  of  a  revolving  cylinder,  running  on 
rubbered  tires,  whose  movements  can  be  graduated  by  the  movement  of  a 
handle,  is  the  one  most  to  be  commended.  Not  less  worthy  of  mention  is  the 
model  shown  in  Fig.  40.  Here  adjustment  is  effected  by  revolving  the  sole- 
noid bv  means  of  the  insulating  spokes  fixed  to  the  disc  at  its  base. 

'D'ARSONVAL'S  bipolar  coil  of  high  tension.— This 
apparatus  is  made  up  of  an  inner  and  an  outer  coil,  without  any  direct  com- 
nuuiication  l)etwecn  them.  The  inner  or  secondary  coil  is  formed  of  a  single 
layer  of  medium-sized  copper  wire,  making  many  turns  about  a  central  insu- 
lating cylinder.  The  currents  derived  from  its  terminals  are  employed  in 
double  effluvation.  The  outer  or  inducmg  coil  rests  on  two  insulating  supports. 
It  consists  of  four  turns  of  thick  copper  wire,  wound  parallel,  and  at  some 
distance  from  the  inner  coil.  Its  terminals  are  connected  with  the  external 
armatures  of  the  Leyden  jars.  This  primary  coil  can  be  moved  to  and  fro 
about  the  secondary.  When  centrally  situated,  the  currents  derived  from  the 
secondary  terminals  are  of  equal  density  and  of  opposite  sign  ;  but  as  it  is 
made  to  approach  one  or  other  extremity,  this  proportion  becomes  altered, 
so  that  the  density  at  one  pole  is  increased  while  that  of  the  other  diminishes. 


32 


RADIO-THERAPY 


This  allows  of  either  bipolar  or  unipolar  effects  being  produced,  or  effluva 
tion  to  be  practised  with  currents  of  unequal  density. 

GUILLEMINOT'S  SPIRALS.— In  resonators  formed  of  wire  wound 
into  a  helix  or  solenoid,  the  energy  of  the  electrostatic  field  developed  by  the 
inducing  spirals  is  only  to  a  very  limited  extent  utilised  in  the  production  of 
induced  currents.  For  the  form  of  the  resonator  of  Oudin  does  not  permit 
the  powerful  oscillatory  field,  created  in  the  vicinity  of  the  spirals,  to  be  em- 
ployed in  generating  bipolar  currents.  Dr.  Guilleuiinot  has,  however,  by 
changing  the  form  of  the  resonator  from  a  helix  to  a  spiral  been  able  to 
utilise  the  energy  of  the  field  in  producing  bipolar  effects.  The  results  of  his 
experiments  were  published  in  1901.  The  resonator  devised  by  him  consists 
of  a  spiral  of  15  to  20  spires  of  copper  wire  held  in  position  by  insulating 
cords  which  radiate  from  a  central  nave  to  the  periphery  of  the  circular 
frame  work  which  supports  it.  The  innermost  spire  has  a  diameter  of  20  to 
30  centimetres.  The  distance  between  the  successive  spires  is  about  18  mm. 
centrally,  but  somewhat  increases  towards  the  periphery.  The  central  extremity 


Fig.  39.    Small   H.  F.  Apparatus,  without   Solenoid.    {Iscntlwl,    London.) 


of  the  spiral  is  connected  with  the  nave,  which  provides  a  socket,  into  which 
the  spider  electrode  of  Tnichot  can  be  fixed,  or  with  which  any  other  electrode 
can  be  attached  directly  or  by  means  of  a  flexible  cord.  The  outer  end  of  the 
spiral  is  connected  with  the  binding  screw  fixed  in  the  supporting  frame. 

Such  a  spiral  can  be  influenced  by  currents  of  high  frequency  derived 
from  the  external  armatures  of  the  condensers.  The  effluve,  however,  will 
differ  according  to  the  mode  of  connecting  the  armatures  with  the  wires  of 
the  spiral.    For  the  central  effluve  obtained   by  influencing  the  outer  spirals 


NOTES  OX  IXSTRCMEXTATIOX 


33 


is  more  soft  and  tractable  than  that  induced  externally  by  intUtencing  the 
central  spires.  Bipolar  effects  can  also  he  produced  by  placing  one  or  more 
of  the  intermediate  spirals  in  circuit  with  the  outer  coats  of  the  Leyden  jars. 
With  a  i6-inch  spark  coil  and  a  primary  current  of  6  to  8  amperes,  the 
maxinnnn  effect  is  obtained  by  connecting  the  armatures  with  a  single  spire. 


with  Sulenuid  under  Table. 


This  is  the  condition  most  favourable  to  the  study  of  the  phenomena  of  high 
frequency  for  the  action  of  the  inducing  spirals  on  one  amnlur  is  thereby 
eliminated. 

In  studying  (from  centre  to  periphery)  the  length  of  the  sparks,  which 
tend  to  pass  between  the  spires,  it  is  found  that  they  are  least  at  the  centre 
and  increase  up  to  the  union  of  the  )4  internal  with  the  4  external  spires, 
after  which  they  rapidly  diminish  in  size.  These  results  arc  ci instant,  what- 
ever be  the  intensity  of  the  primary  current  or  kind  of  s])iral  employed. 

The  influence  of  two  spirals  on  each  other  is  equally  interesting. 

Tho  subject  can  be  best  studied  in  considering  separately — 

(a)  The  relative  influence  of  an  active  and  a  passive  spiral  approached 
to  each  other. 


34 


RADIO-THERAPY 


(b)  The  interrelation  of  two  active  spirals  which  do  not  reciprocally 
influence  each  other. 

(c)  The  reaction  between  two  active  spirals  which  mutually  affect  each 
other. 

(a)  The  relative  inHuencc  of  an  active  and  a  passive  spiral  approached 
to  each  other.  If  the  surfaces  of  the  two  spirals,  brought  in  relation  to  each 
other,  be  parallel  and  their  centres  in  the  same  horizontal  line,  the  influence  of 
the  spirals  on  each  other  varies  according  to  the  direction  of  their  winding. 

If  the  two  spirals  wind  in  a  direction  contrary  to  each  other  (Fig.  42), 
the  brush  discharge  which  issues  from  the  central  spire  of  the  active  spiral  is 
diminished  on  both  sides  of  it.  At  the  same  time  an  intense  efiiuvation  is 
induced  about  the  central  spire  of  the  other.  The  closer  the  spirals  are 
brought  to  each  other,  the  more  beautiful  and  intense  do  the  interpolar 
effects  become,  a  free  exchange  of  efifluve  taking  place  between  them. 


Fig.  41.    D'Arsonval  Bipolar  Coil,  High  Tension.     (Schall,  London.) 

These  interpolar  effects  are  abolished  and  effluvation  ceases  when  the 
central  ends  of  the  two  spirals  are  joined  by  a  conducting  wire.  The  connec- 
tion to  earth  of  the  central  spire  of  the  passive  spiral  has  but  little  influence 
on  the  effluve  derived  from  the  active  spiral. 

When  the  two  spirals  wind  in  the  same  direction  (Fig.  43)  very  differ- 
ent effects  are  produced.  The  brush  discharge  about  the  central  spire  of  the 
active  spiral  is  but  little  modified  by  its  proximity  to  the  passive  spiral.  It 
is  only  when  the  distance  between  them  is  less  than  20  to  30  centimetres  that  it 
becomes  asymetrical,  being  almost  absent  on  the  side  facing  the  passive  spiral 
and  very  vigorous  on  the  side  turned  away  from  it.  It  presents  the  appear- 
ance of  being  blown  away  by  the  intensity  of  the  charge  induced  in  the  passive 
spiral,  which,  however,  is  very  meagre  when  compared  to  the  free  efiluvation 


NOTES  OX  IXSTRUMEXTATION 


35 


observed  in  the  preceding  case.  It  is  needless  to  say  that  no  interspiral 
phenomena  are  produced  nor  does  ctifluvation  cease  when  the  inner  extrem- 
ities of  the  two  spirals   are  coupled  together.     Connection  to  earth  of  the 


Fig.   42.   Two     Spirals 
Directions 


*•  s 

Two  Spirals  in  Same  Direc- 
tion. 


central  extremity  of  the  passive  spiral  not  only  re-establishes  the  symmetry 
of  the  effluve  of  the  active  spiral,  but  also  diminishes  it. 

(b)  Effects  obtained  zvitli  tzvo  active  spirals  which  do  not  reciprocally 
influence  one  another.  For  purposes  of  demonstration,  let  it  be  supposed 
that  A°  and  B°  are  the  peripheral  extremities  of  the  spirals,  A  and  B  respec- 
tively, and  A*  and  B*  points  in  their  first  spires,  which  mark  the  end  of  the 
inducing  circuit  and  the  commencement  of  the  induced,  whilst  L^  and  U  are 
two  batteries  of  Lcyden  jars,  whose  external  armatures  are  connected  with 
the  poles  of  the  inducing  spires.  The  effects  observed  will  differ  according 
to  the  method  adopted  in  coupling  the  armatures  of  the  condensers  with  the 
coils  of  the  spirals,  and  also  with  the  direction  of  winding  of  the  spirals. 


-rs fl 

Fig.  44.    .\ctive.  nnt  Inlluencing  One  Another. 


Case  I.  Where  the  flow  of  the  current  is  homologous  and  centripetal 
in  both  spirals. — Here  the  direction  of  winding  of  the  two  spirals  is  the 
same  (Fig.  44).  When  mounted  in  quantity,  the  current  derived  from  L' 
flows  from  A"  to  A<!>  in  the  spiral  A.  and  from  B°  to  B^   in  the  spiral  B.  the 


36 


RADIO-THERAPY 


points  A(&  and  B^  being  connected  with  the  battery  of  condensers  at  L^ 
When  the  spirals  are  mount'  d  in  tension,  the  discharge  circuit  of  the  inducing 
current  is  L\  A°.  A®,  B°,  B  ^  ,  U.  The  effects  of  this  mode  of  accouplement 
are:  (i)  The  effluvation,  which  takes  place  between  the  central  spires  of 
Au  and  Ew,  is  not  abolished  by  connecting  their  inner  extremities;  on  the 
contrary,  the  conductor  by  which  connection  is  established  itself  becomes  the 
centre  of  a  lively  brush  discharge;  (2)  Connection  to  earth  of  the  central  end 
of  one  spiral  tends  to  increase  ihe  effluve  of  the  other,  and  when  the  spirals 
are  mounted  in  tension  this  effluve  attains  to  the  length  that  it  would  possess 
had  this  spiral  alone  been  placed  in  the  circuit,  being  somewhat  less  dense, 
but  more  soft  and  tractable. 

Case  II.  Where  the  current  flows  centripetally  in  the  one  spiral  and 
centrifugally  in  the  other  (Fig.  45). — To  bring  about  this  result  the  spirals 
must  wind  in  contrary  directions.  They  may  be  mounted  either  in  quantity 
or  in  tension. 

When  mounted  in  quantity  the  inducing  current  derived  from  L^  flows 
centripetally  from  A"  to  A<l>  in  the  spiral  A  and  centrifugally  from  B<^  to  B° 
in  the  spiral  B.  When  mounted  in  tension,  the  circuit  of  discharge  of  the 
inducing  current  is  L^  A°  A«»  B(i  B°  L".  The  effects  observed  in  this  case 
are  opposite  to  those  noticed  in  the  preceding.     Effluvation  ceases  when  the 


Fig.  45.     Bipolar. 


central  ends  of  the  two  spirals  are  united;  connection  with  earth  of  one  of 
the  central  spires  tends  to  lessen  the  effluve  of  the  other. 

From  a  consideration  of  the  preceding  cases  it  will  appear  that  the 
spirals  receive  a  charge  which  will  be  either  similar  or  opposite  according  to 
the  mode  of  couplage. 

The  charge  is  similar — 

(i)  When  the  spirals  are  mounted  in  quantity,  so  that  L^  A°  A^  L" 
and  L'  B°  B^  L"  are  the  two  inducing  circuits  connecting  the  condensers 
L'  and  V. 

(2)  When  they  are  mounted  in  tension,  so  that  the  inducing  current 
traverses  the  circuit  L^  A°  A<^  B°  B^    L". 

(3)  And  judging  by  analogy  of  effect  it  will  be  so  when  a  passive 
spiral  is  influenced  by  an  active  spiral,  wound  in  the  same  direction  as  itself. 

On  the  other  hand,  a  difference  of  charge  is  observed — 

(i)   When  the  spirals  are  mounted  in  quantity,   so  that  L^  A°  A<?»    U 

and  L'  B0   B°  and  L"  are  the  circuits  of  the  inducing  currents  circulating  in 

the  spirals  A  and  B. 

(2)   When  mounted   in   tension,   so   that   U   A°   A?    B*    B°   L"  is  the 

circuit  of  discharge  between  the  condenser  L^  and  L". 

_(3)   Judging  by  similarity  of  effects,   when  the  active  spiral   is  wound 

in  a  direction  contrary  to  that  of  the  passive  spiral,  with  which  it  is  in  relation. 


NOTES  OX  IXSTRI-MEXTATIOX  37 

Eifccts  obsi'i-fcd  z>.7;i-;v  l:co  artizu'  spirals  imitiidlly  iuHitcncc  one  cdi- 
otlicr. — As  the  proximity  of  the  spirals  to  each  other  and  their  mode  of 
couplage.  under  certain  conditions,  gives  rise  to  similar  phenomena,  it  is 
evident  that  the  efifects  which  accrue  from  a  combination  of  both  will  be  pro- 
portionately increased.  For  instance,  if  the  two  spirals  A  and  B,  wound  in 
contrary  directions  and  mounted  in  tension  (so  that  L^  A°  A<?>  Bf>  B°  L' 
forms  the  discharge  circuit  of  the  inducing  current),  be  approached  to  each 
other,  tile  most  brilliant  intcrjjolar  effects  manifest  themselves,  and  a  lively 
brush  discharge  takes  i)lace  between  the  central  s])ires  of  A  and  B.  These 
interpolar  effects  are  abolished  and  eftluvation  cea.ses  when  the  inner  extrem- 
ities— Aw  and  Bw — of  the  two  spirals  are  joined  to  each  other.  Connection 
with  earth  of  the  central  spire  of  B(j  has  very  little  influence  on  the  effluve 
of  A  (J. 

But  if  the  two  .-[jirals  .A  and  B  be  wound  in  the  same  direction  and 
mounted  in  tension  (so  that  U  A°  A-p  B°  B0  L  is  the  circuit  of  discharge 
of  the  inducing  current),  no  interpolar  effects  will  be  observed  when  the 
spirals  are  apprfsached  to  each  other,  nor  will  the  connection  of  the  central 
ends  of  the  two  si)irals,  to  each  other,  catise  the  effiuvation  to  cease;  again, 
connection  with  earth  of  the  central  end  of  one  spiral  increases  the  effluve 
of  the  other. 

If  a  neutral  capacity — say,  the  hand  or  body  of  a  patient — be  intro- 
duced between  two  spirals,  coupled  so  as  to  produce  interpolar  efifects,  it  is 
at  once  deluged  by  the  free  effluve  from  both,  but  with  spirals  in  which  the 
flow  of  the  current  is  homologotis,  the  opposite  effect  is  produced,  i.e.,  an 
effluve  issues  from  the  capacity  to  impinge  on  their  spires. 

Method  of  ciiifloyiii;^  a  single  spiral. — It  has  been  already  mentioned 
that  unipolar  or  liipolar  effects  can  be  produced  with  a  single  spiral  according 
to  the  mode  of  couplage.  Unipolar  effiuvation,  however,  is  the  result  it  is  best 
fitted  to  produce.  It  can  be  employed  to  administer  a  cephalic  douche.  The 
spiral  is  then  attached  to  the  ceiling  at  a  convenient  height  above  the  bead  of 
the  patient,  who  either  sits  or  .stands  beneath  it.  Its  outermost  spire  is  in- 
fluenced by  a  current  of  high  frequency,  derived  from  the  external  armatures 
of  the  Leyden  jars.  At  the  same  time,  in  the  central  socket,  which  forms  the 
hub  of  the  spiral,  is  fixed  the  spider  electrode  of  Truehot.  A  single  spiral 
can  also  be  used  with  any  other  electrode  either  directly  attached  to  the  central 
socket  or  connected  with  it  by  a  conducing  cord. 

Mode  of  iitilisiii;^  two  spirals  in  z^ibratory  treatment.- — To  derive  the 
full  benefit  of  the  powerful  electrostatic  field  developed  between  the  spirals 
the  patient  must  be  placed  between  them.  They  may  or  may  not  be  fitted 
with  special  electrodes,  according  to  the  requirements  of  the  case.  To  pro- 
duce bipolar  effects,  the  spirals  must  be  so  arranged  that  the  direction  of 
winding  in  the  one  is  opposite  to  that  in  the  other.  This  causes  the  inducing 
current  to  circulate  centripetally  in  the  one,  while  it  flows  centrifugally  in  the 
other.  When  so  arranged,  the  part  submitted  to  treatment  is  deluged  by  an 
effluve,  which  proceeds  from  both.  The  effect  ])roduccd  can  be  regulated 
by  moving  the  spirals  closer  to  each  other  or  further  ajjart.  For  homopolar 
effects,  the  wires  of  the  spirals  must  wind  in  the  same  direction;  an  effluve 
will  tlu-n  be  seen  issuing  from  the  body  of  the  i)atient  and  passing  outward*' 
towards  them.  Dr.  Gitilleniiuot  considers  this  a  |)urely  relatixe  phenomenon. 
and  explains  it  in  the  following  way' 

"If  a  neutral  cai)acity  be  surrounded  by  conductors  in  the  same  state 
of  electrification,  the  effluve  which  jiroceeds  from  these  conductors  do  not 
converge  but  --hiin  tlu'  c-lectro-static  field  between  ilu'ni.  l^'or  this  reason  a 
body  intrfxluced  into  this  field  receives  \ery  little  efthuation  from  them,  as 
that  coming  from  one  conductor  is  re])ulsed  and  lield  in  check  by  that  issuing 
from  the  conductor  diametrically  o])i)osiie  to  it.  '\'\\v  neiUral  body,  however, 
soon  becomes  charged  with  an  induced  current  of  opposite  sign,  rind  is  free 
to  di-ebarge  its  effluve  against   all   the  conductors  surrounding  it." 

This  he  proves  by  the  following  very  convincing  experiment: 

"If  a  metallic  ring,  fixed  in  an  in--ulating  handle,  be  connected  with  a 
source  of  high  fref|uency.  sucli  .i^  ll.e  '-esonator  of  Oiidin.  the  D' .Irsoir.'al 
Tran'-fornicr    or    a    vi)ir;il,    this    ring    emits    an    el'thue    wliit-h    is    most    marked 


38 


RADIO-THERAPY 


eccentrically ;  for  the  rays  passing  centripelally  are  checked  and  opposed  by 
those  proceeding  from  the  part  diametrically  opposite.  If  a  finger  be  brought 
in  external  relation  with  the  ring,  it  receives  an  effluve  from  it,  but  emits 
very  little.  If,  on  the  other  hand,  it  be  introduced  into  the  ring  centrally, 
it  will  be  seen  to  emit  a  brisk  brush  discharge,  but  to  receive  next  to  nothing." 

In  summing  up,  it  may  be  said : 

(i)  A  capacity  both  receives  and  emits  an  efiluve  when  placed  in  the 
vicinity  of  a  conductor  charged  to  a  very  high  potential.  This  is  the  case 
where  one  spiral  alone  is  employed. 

(2)  The  efiluve  that  issues  from  a  neutral  capacity,  placed  between  two 
conductors,    which   mutuallv   influence   each   other,    is   minimised   and   lost   in 


4').   Reus'  Cone; 


Fig.  47.     Hand  Electrode. 
{I'>caii.  London.) 


Fig.  4'>.     Rectal 
Fkcticde. 


the  deluge  of  effluve,  which  it  receives  from  these  conductors.  This  is  the 
case  of  bipolar  effluvation  with  a  capacity  introduced  between  the  spirals. 

(3)  The  effluve  from  a  capacity  introduced  between  two  conductors 
emitting  a  homopolar  effluvation  is  increased  while  that  of  the  conductors 
themselves  is  minimised  by  the  electro-static  field  intervening  between  them. 
This   is   the  case  with   spirals  mounted   so  as   to   produce  homopolar   effects. 

Besides  this,  a  patient  can  also  be  submitted  to  the  influence  of  one 
spiral,  and  the  effluve  of  the  other,  by  connecting  him  with  the  one  by  a  hand- 
electrode  and  placing  him  in  the  vicinity  of  the  other,  the  spirals  being 
meanwhile  arranged   either   to   produce  homopolar   or  bipolar  effects. 


NOTES  OX  IXSTRL-MENTATJOA' 


39 


Reus'  Cones  (Fig.  46). — This  apparatus  occupies  an  immediate  place 
between  the  tiat  spiral  of  Dr.  GiiiUcminot  and  the  longitudinally  coiled 
resonator  of  Dr.  Oudin.  It  essentially  consists  of  a  biconvex  lenticular  disc 
(33  inches  in  diameter)  formed  of  ebonite  or  some  other  good  insulating 
substance,  upon  which  a  layer  of  wire  (No.  9,  B.  W.  G. )  is  coiled  so  as  to 
form  two  cones,  united  by  their  bases.  The  wire  makes  31  spiral  turns 
on  each  side  of  the  disc.  As  the  peripheral  extremity  of  the  two  cones 
are  continuous  with  each  other,  and  ihe  direction  of  their  winding  contrary, 
the  inductive  eti'ects  of  the  spirals  is  always  a  maximum.  When  in  use, 
the  central  extremity  of  one  cone  is  connected  with  the  external  armature 
of  a  Leyden  jar,  while  the  corresponding  armature  of  the  other  condenser 
is  connected  by  an  adjustable  contact  clip  with  one  of  its  intermediate  spirals, 
so  as  to  obtain  a  maximum  of  output  on  the  free  central  terminal,  to  which 
the  electrode   is   attached.     The  apparatus   is  available   for  use  as  a  cephalic 


Fig.  49.  H.  F.  Rose. 
{Sanitas  Electl. 
Co.,    London.) 


Fu;.     50.     Ciin(k-n>er. 
(I  sen  thai,   London.) 


51.  Disc.  Elec- 
trode. (Scluill. 
London.  ) 


douche  or  for  unipolar  applications,  but  two  cones  are  required  for  double 
effluvalion  and  bipolar  applications. 

.Ipparaius  Peculiar  to  Itidividnal  Methods  of  Application. — These  may 
be  best  considered  in  reference  to  llie  nutliods  to  which  they  apply.  The 
four  recognised  methods  of  api)lic.ition  arc  :  Derivation,  b-tfluvation,  Con- 
densation and  Autoconduction. 

For  treatment  by  the  Stabile  nu'llioil  nf  1  )iTi\  .itioii  u  i-  rniuiri,'  li.iiid- 
electrodes  (Fig.  47),  both  for  unipolar  antl  bipolar  ai)i)lications  ;  or  llat  disc 
electrodes  (Fig.  51).  For  rectal  use  we  require  the  electrodes  shown 
in  Fig.  48.  For  labile  applications  we  employ  cither  the  globular,  the 
T-shai)ed    cylinrlrical    or    llic    roller   clcclrodi- :    whiKt    for    iiilerrnpted    bipolar 


40 


RADIO-THERAPY 


applications  we  use  various  sized  brushes  for  general  purposes,  and  an  Erb- 
model  electrode  for  parts  where  a  finer  graduation  of  effect  is  desired. 

In  EFFLUVATION  we  make  use  of  a  rose-efHuve,  of  condenser 
electrodes,  and  of  vacuum  and  water  electrodes. 

THE  ROSE  OR  EFFLUVER  (Fig.  49)  essentiallv  consists  of  a  flat 
disc  of  metal  studded  with  concentric  rows  of  blunt  pointed  pegs.  In  the  im- 
proved models  all  the  metal  part  of  the  electrode  (except  the  projecting  tips 
of  each  peg)   is  heavilv  insulated. 

THE  CONDENSER  ELECTRODE  (Fig.  50)  is  formed  of  a  metal  or 
graphite  carbon  conducting  rod  enclosed  in  an  insulating  sheath  of  glass  or 
ebonite.  They  constitute  with  the  integument  of  the  part,  to  which  they  are 
applied,  a  condenser.  The  delicate  violet  coloured  sparks  thrown  out  by  these 
electrodes,  and  also  by  the  vacuum  and  water-electrodes,  are  termed  "Euco- 
inidcs,"  to  distinguish  them  from  the  more  painful  "Spark"  discharges  and 
the  gentle  "Effluve"  from  the  Rose  or  Effluver. 

VACUUM  ELECTRODES  are  made  of  vulcanite  or  glass,  and 
exhausted  to  various  degrees  of  vacuum.  The  discharge  proceeds  from  a 
small  pin,  placed  centrally  in  the  attached  extremity  of  the  electrode.  When 
the  exhaustion  is  high.  X-ray  effects  are  said  to  be  produced. 


Fig.  52.     Fluid  Electrode.      {Scliall.  London.) 


FLUID  ELECTRODES  (Fig.  52).— These  are  formed  of  glass  or 
ebonite,  with  the  interspace  between  the  sheath  and  central  pin  filled  with  a 
slight  acidulated  saline  solution.  It  is  not  unusual  to  convert  a  vacuum 
electrode  in  which  the  vacuum  is  damaged  into  a  water  electrode,  so  as  to 
save   expense  of   having   it   exhausted. 

For  treatment  by  Condensation  we  require  a  couch  condenser  for 
general  condensation,  and  various  shaped  spli)it  caiidoiscrs  for  more  local- 
ised applications. 

THE  COUCH  CONDENSER  (Fig.  53)-— It  has  been  given  various 
forms  by  different  makers.  In  some  it  is  a  massive,  lumbersome  article  of 
furniture,  better  suited  to  the  spacious  receiving-rooms  of  a  general  hospital 
than  to  the  private  offices  of  the  consultant  or  general  practitioner;  in  others 
its  dimensions  have  been  whittled  down  to  a  size  that  renders  its  use  more 
awkward  than  efficacious.  For  consulting  rooms  in  which  the  amount  of 
available  snace  is  limited,  the  bent-wood  couch  shown  in  Fig.  5,3  is  most 
suitable.  It  is  at  once  strong,  useful  and  elegant,  and  does  away  with  the 
multitude  of  unseemly  expedients  that  have  to  be  resorted  to  so  as  to  render 
the  chair-condenser  effective.  It,  moreover,  allows  the  patient  to  rest  in  an 
easy,  reclining  position,  the  advantages  of  which  are  too  well  known  by  the 


NOTES  OX  IXSTRi'MEXTATIOX 


41 


experienced  operator.  With  the  exception  of  the  seat,  it  in  nowise  differs 
in  construction  from  those  usuallj'  met  with  in  furniture  stores.  The  seat  is 
a  stout  metallic  sheet,  carefully  fitted  to  the  body  of  the  couch,  and  coated  on 


Hi;-;li-i-"rc(]nency  Couch.      {II.  li'.  Cox,  L(jndon.) 


both  sides  with  a  layer  of  some  insulating  material.  At  the  head  the  sheet 
somewhat  protrudes  to  allow  of  the  attachment  of  the  binding-screws,  which 
connect  it  with  an  apparatus  of  high  frequency.  It  is  u.sually  made  of  tin, 
copper,  lead  or  zinc,  and  forms  that  armature  of  the  couch-condenser  which 


Fi<;.  54.     Splint  Condensers. 


is  always  active.  The  insulating  substance-;  employed  as  dielectrics  are 
various.  Some  makers  use  a  horsehair-i)added  cushion  to  cover  the  metallic 
sheet:    but    its    dielectric    capacity    is    very    limited,    Imtli    on    account    of    the 


42 


RADIO-THERAPY 


nature  of  the  substance  of  which  it  is  made  and  the  thickness  of  the  layer 
required  to  secure  perfect  insulation.  Reus  favours  a  composite  material, 
composed  of  mica,  shellac,  wool  fibre  and  well-pulped  paper,  which  is  care- 
fully prepared  and  rolled  in  sheets.  In  appearance,  it  much  resembles 
papier-mache,  but  is  more  durable  and  easily  applied,  not  so  liable  to  crack, 
and  takes  a  better  polish.  Another  material  equally  useful  is  coarse  fibrous 
felt,    impregnated    with    shellac    and    then    compressed.       Guttapercha    and 


Fig.  55.     Upright  Cage.      (Sanitas    Elec- 
trical  Co.,   London.) 


Fig.   56.   Upright  Cage.    (IVatson   &  Sons, 
London.) 


ebonite  have  been  similarly  employed.  All  of  these  are  good  dielectrics,  not 
easily  pierced  by  sparks;  while  the  thinness  of  the  coat  required  much  inten- 
sifies the  inductive  effects. 

SPLINT  CONDENSERS  (Fig.  54)  are  made  of  aluminium,  sheet  lead 
or  wire-gauze  and  encased  except  at  the  points  where  the  connections  are 
made  in  a  close-fitting  layer  of  the  composite  material  already  described.     The 


NOTES  OX  lA'STRCMEXTAriOX 


43 


patient,  to  whom  the  splints  are  applied,  is  placed  on  an  insulated  couch  and 
connected  by  means  of  a  disc  or  hand  electrode  with  one  pole  of  the  small 
solenoid,  while  the  wire  from  the  opposite  pole  is  attracted  to  the  terminal 
binding  screw  on  the  splint,  which,  of  course,  has  to  be  carefully  adapted 
to  the  contour  of  the  part  to  which  it  is  applied.  In  treatment  by  general 
autoconduction  the  cage  of  autoconduction  is  a  necessity,  while  in  local 
autoconduction  the  smaller  solenoids  which  are  shown  in  Fig.  55  are  em- 
ployed. 

THE  SOLENOID  OR  CAGE  OF  AUTOCONDUCTION  is  a  large 
helix,  7  feet  long  by  36  to  48  inches  in  diameter,  formed  of  18  to  20  turns  of 
stout  copper  wire  (15  to  20  mm.)  ribbon  or  tubing.  Its  spirals  are  held  in  posi- 
tion by  suitable  insulating  supports,  which  may  either  be  cords  and  tapes  of  silk 
or  of  specially  prepared  tiax.  or  pillars  and  bars  of  ebonite  or  well-paraffinated 
wood.  As  the  solenoid  is  intended  for  the  reception  of  the  body  of  the 
patient,   it  must  be  sufticiently   large  and   spaciou'^  not  only  to  accommodate 


{Saiiitas    Electrical    Co.,    London.) 


it.  but  also  to  allow  of  easy  access  and  enclosure.  Those  of  the  dimensions 
above  mentioned  have  been  found  to  well  serve  the  purpose.  There  are  two 
chief  types  of  solenoids  in  general  use,  the  one  intended  for  use  in  the  ver- 
tical, the  other  in  the  horizontal  position.  The  arrangement  of  the  wire- 
spirals  and  their  number  differs  in  the  apparatus  of  different  makers.  In 
some  forms  of  the  large  upright  solenoid  the  wires  are  permanently  fixed  to 
the  wooden  framework  of  the  cage,  a  door  being  provided  to  admit  the 
patient ;  in  others  the  wire  coils  are  suspended  by  silken  tapes  or  cords,  and 
can  be  drawn  up  like  a  Venetian  blind  to  afford  access.  The  break  in  the 
continuity  in  the  wire  of  the  spirals  in  the  first  case  causes  a  certain  amount 
of  sparking  and  interruptirm  in  the  flow  of  the  current,  and  is  for  this 
reason  not  so  advantageously  employed  as  the  other,  which,  when  not  in  use, 
can  be  drawn  up  to  the  ceiling  so  as  to  place  more  space  at  the  disposal  of 
the  operator.     In  the  horizontal   model   the  wires  are  either  fixed  about  the 


44 


RADIO-THERAPY 


insulating  couch  or  else  they  can  be  drawn  into  position  after  the  patient  has 
been  placed  upon  it  by  a  cord  and  pulley  arrangement.  Although  both  types 
of  solenoids  can  be  used  in  treatment  by  Apostoli's  method,  still  the  vertical 
model  (Fig  56)  is  to  be  preferred,  more  especially  in  dealing  with  the 
hypersensitive,  the  infirm  and  the  bedridden.  It  must,  however,  be  remem- 
bered that  whatever  may  be  the  form  of  solenoid  adopted,  its  terminals 
require  to  be  connected  with  a  source  of  currents  of  high  frequency.  This 
can  be  effected  by  connecting  them  with  the  two  poles  of  the  solenoid  of 
high  frequency;  but  they  are  more  often  directly  united  to  the  external 
armatures  of  the  condensers  in  the  apparatus  of  production,  thus  deriving 
a  current  of  greater  potential.  The  cage  is  also  usually  provided  with  an 
induction  ring  with  an  incandescent  lamp  or  Gcisslcr  tube,  whereby  the 
intensity  of  the  current  induced  in  the  body  of  the  patient  can  be  roughly 
estimated. 

The  apparatus  in  use  for  local  autoconduction  (Fig.  58)  is  similar  in 
construction  but  smaller  in  dimensions  than  the  wire-frame  horizontal  cage 
employed  in  general  autoconduction.  In  the  majority  of  cases  a  single  limb  or 
region   is   all   that   is   introduced   into   these   solenoids,    but   the   limit   can   be 


Fig.  58.    Local  Autoinduction  Cage. 


Fig.  59.     Milliampere-meter. 


extended  to  embrace  the  entire  trunk  below  the  sJioulder  girdle.  It  i^ 
actioned  by  connecting  its  terminals  with  the  poles  of  the  small  solenoid  of 
high  frequency  or  the  two  terminals  of  a  bipolar  resonator,  by  varying  the 
self-induction  of  whose  spirals  a  graduation  of  effect  can  be  produced.  In  ex- 
tended local  autoconduction  the  patient  is  placed  upon  an  insulating  couch, 
about  which  the  cage  is  fixed  so  as  to  leave  the  head  and  shoulders  outside  the 
sphere  of  direct  electro-magnetic  influence.  In  purely  local  autoconduction 
the  limb  is  centrally  introduced  into  one  of  the  various  smaller  solenoids  and 
rests  upon  the  insulating  splint  condenser  in  its  interior.  It  can  be  connected 
with  a  pole  of  the  solenoid  of  autoconduction,  as  in  the  combined  method 
of  Apostoli,  or  remain  free  from  contact,  as  in  the  simpler  method  of  D'Arson- 
val  instruments  for  measuring  the  intensity  of  the  eurrents  passing  into  the 
body  of  the  patient.  Besides  the  voltmeter  and  ammeter,  which  registers  the 
amount  of  current  passing  into  the  primary  of  the  induction  coil,  it  is  at  all 
times  necessary  to  know  the  intensity  of  the  current  passing  into  the  body  of 
the  patient.  This  can  be  measured  by  the  universal  galvanometer  of  Gaiife, 
a  dead  beat  milliampere-meter  of  the  D'Arsonval  type  (Fig.  59),  in  which 
the   elongation   of  a   fine  metallic   wire    (made   of  an   alloy  of  platinum   and 


XOTES  OX  IXSTRCMHXTATIOX 


45 


iridium)  causes  the  passage  of  a  current  through  to  influence  the  movement 
of  the  light  pointer  which  then  indicates  the  intensity  of  the  current  passing 
through  the  circuit.  This  instrument,  to  be  of  real  service,  should  register 
as  far  as  up  to  700  m/a. 

APPARATUS  FOR  X-RAY  WORK.— The  focus-tube  is  the  most 
essential  part  of  an  X-ray  outfit.  Without  endeavouring  to  trace  in  detail 
the  evolution  of  these  from  the  primitive  Gcisslcr  and  Crookcs  tube  of 
laboratory  fame  to  the  latest  and  most  improved  model  now  on  the  market, 


'=^y^^ 


Fig.  60. 


it  may  be  said  that  as  cathodic  tubes  were  never  specially  designed  for  X-ray 
work,  there  was  always  a  considerable  amount  of  diffusion  of  the  cathodic 
stream  with  the  inevitable  result — bad  definition  at  short  distances  from  the 
tube.  The  first  real  step  towards  improvement  in  instrumentation  was  the  use 
of  the  focus  tube,  in  which  the  stream  of  cathodic  rays  are  brought  to  a  focus 
at  some  part  of  the  surface  of  the  anode.  By  thus  limiting  the  size  of  the 
area  from  which  the  X-rays  proceed,  a  better  definition  of  shadows  cast  by 
objects  held  close  to  the  tube  could  be  obtained. 

The   next   important   step   forward   in   the  development   of  these   tubes 
was  the  introduction  of  a  target — the  anti-cathode  of  Professor  SUvanus  P. 


Fig.  61.     Regulating   Record   Tube 


Cox.    Ltd..    London.) 


Tlioinf'son — quite  distinct  from  the  anode.  These  hi -anodal  tubes  (Fig.  60), 
on  account  of  their  trilling  cost  and  general  utility,  have  been  extensively 
used,  both  in  this  country  and  on  the  continent.  The  addition  of  a  regenera- 
tive device  for  regulating  the  vacuum  of  the  tube  (as  in  Fig.  61)  has  so 
greatly  increased  tlieir  life  that  no  further  improvements  in  this  direction  can 
be  effected.  The  gradual  rise  of  vacuum  resistance  of  a  tube  with  continued 
use  is  at  present  a  point  beyond  our  control  ;  but  certain  compensatory 
features  have  been  introduced  in  the  construction  of  later  models  that  enable  us 
to   secure   a   greater   degree   of   constancy.     The    tubes   provided    with    these 


46 


RADIO-THERAPY 


devices  are  known  as  "regenerative  tubes,"  in  contradistinction  to  the 
"ordinary"  tubes  generallv  made  use  of. 

REGENERATIVE  TUBES.— The  vacuum  of  a  hermetically  sealed 
tube  may  be  altered  by  one  of  the  following  devices : 

(i)  By  the  application  of  heat.  A  tube  whose  resistance  has  risen 
beyond  the  working  limit  may  temporarily  be  restored  by  warming  the  glass 
from  the  outside  by  means  of  a  spirit  lamp,  sand-bath  or  Bunsen  burner; 
this  can  also  be  effected  by  forcing  a  powerful  electric  current  through  the 
tube  till  the  anti-cathode  grows  incandescent.  Although  this  method  is 
applicable  to  all  tubes,  the  "Double-Bulb"  tube    (shown  in  Fig.  62)    allows 


Double  Bulb  X-ray  Tube.      (Iscntlial,  London.) 


of  this  method  of  regeneration  to  be  used  to  the  best  advantage.  The  most 
prominent  characteristic  of  this  tube  is  the  addition  behind  the  working  bulb 
of  a  regenerating  chamber,  the  heating  of  which  by  the  passage  of  the  electrical 
discharge  allows  the  condensed  gas  which  clings  to  its  inner  wall  to  be 
driven  into  the  main  tube,  and  thus  lower  its  resistance. 

(2)  By  the  introduction  of  substances  zvhich  absorb  gases  at  ordinary 
temperatures  and  yield  them  up  when  heated.  The  substances  more  com- 
monly employed  are  mica  discs,  sodium  and  potassium  hydrate,  palladium, 
permanganate  of  potash  and  charcoal.     They  are  generally  placed  in  a  small 


Fig.  63.     Chemical   Substance  Regenerator.     {Dean,  London.) 


auxiliary  chamber,  by  the  careful  heating  of  which  the  resistance  of  the 
main  bulb  can  be  gradually  lowered  to  any  required  degree.  An  arrangement 
which  allows  the  necessary  heating  to  be  done  automatically  by  means  of  an 
alternative  discharge  circuit  with  an  adjustable  spark-gap  is  shown  in 
Fig.  63.  When  the  vacuum  in  the  main  tube  rises  beyond  the  desired  limit, 
the  current,  selecting  the  path  of  least  resistance,  passes  through  the  alterna- 
tive circuit  and  heats  the  chemical  in  the  auxiliary  bulb  until  sufficient  vapour 
has  been  driven  into  the  main  chamber  to  lower  its  resistance  to  the  required 
extent.  It  is  evident,  therefore,  that  the  resistance  in  the  vacuum  chamber 
will  depend  on  the  length  of  air-gap  employed. 

The  great  disadvantage  of  all  automatic  regulators  in  which  an  alterna- 


% 


NOTES  OX  IXSTRCMEXTATION  47 

live  patli  of  discharge  is  employed  is  that,  whilst  the  regulatory  sparking  is 
going  on  in  the  by-circuit,  there  is  no  discharge  through  the  main  chamber. 
The  anti-cathode,  therefore,  has  time  to  cool  and  occlude  upon  its  surface 
some  of  the  released  vapour,  which,  when  the  current  reverts  to  the  main 
circuit  and  again  heats  the  target,  may  be  given  off  so  rapidly  as  to  render 
the  vacuum  too  low. 

MECHANICAL  REGENERATION.— Several  attempts  have  been 
made  to  vary  the  penetration  value  of  the  rays  by  altering  the  distance 
between  the  cathode  and  its  target ;  but  as  the  required  manipulative  dex- 
terity their  use  entails  can  only  be  acquired  by  long  practice,  and  after  the 
sacrifice  of  a  great  number  of  tubes,  one  seldom  sees  any  of  these  regenerative 
tubes  used  bv  anv  but  the  inventors  themselves. 

ELECTROSTATIC  REGENERATION.— As  the  charge  generated 
by  electrostatic  induction  upon  the  outer  surface  of  a  focus-tube  when  in 
use  has  a  considerable  eft'ect  upon  the  discharge  passing  through  it,  attempts 
have  been  made  to  regenerate  the  tube  and  lower  its  resistance  by  drawing 
off  this  outer  charge  by  a  connection  with  an  earthed  wire  or  with  the  inner 
surface  of  the  tube.  This  has  been  effected  by  covering  the  neck  of  the 
tube  in  the  plane  of  the  cathode  edge  with  a  ring  of  copper  wire  or  with 
strips  of  tinfoil  and  connectmg  it  by  an  adjustable  spark-gap  with  earth  or 
the  wire  leading  to  the  cathode.  As  the  risk  of  perforation  is  to  some  extent 
increased   by  the  facilities  offered   for  the   passage   of  the   sparks   round   the 


Fig.  64.     Osmosis   Tubes.      {Dean,   London.) 

tube,  Bclingcr  has  suggested  the  use  of  semi-conductors — a  wooden  cylinder 
moistened  with  glycerine  for  the  metallic  coating.  Although  this  method 
of  regeneration  is  very  promising,  there  is  still  a  vast  amount  of  room  for 
improvement. 

BY  OSMOSIS. — Another  and  the  most  promising  method  of  regulat- 
ing the  vacuum  of  a  tube  depends  upon  the  fact  that  certain  metals,  more 
especially  platinum,  when  heated  to  redness,  become  pervious  to  hydrogen. 
If  a  closed  tube  ol  platinum  be  sealed  into  the  auxiliary  chamber  of  a  focus 
tube,  it  will,  when  cold,  be  perfectly  air-tight,  but  when  heated  to  redness 
in  the  flame  of  a  spirit-lamp,  the  hydrogen  from  the  flame  passes  into  the 
bulb,  and  thus  lowers  its  resistance.  As  there  is  no  limit  to  the  supply  of 
hydrogen  that  can  thus  be  passed  into  the  tube,  its  superiority  to  other 
methods  is  obvious.  The  annealing  of  the  platinum,  however,  requires  the 
utmost  care  to  prevent  the  possibility  of  leakage.  This  type  of  regenerator 
is  largely  employed,  and  a  tube  with  this  regulation  is  shown  in  Fig.  64. 
In  some  makes  of  tube,  facilities  are  also  afforded  for  the  removal  of  any 
excess  of  gas  that  has  been  introduced  intn  the  tube,  the  principle  of  action 
being  the  same. 

DEVICES  FOR  COOLING  THE  TARGET.— The  heating  effects  of 
the  cathodic  stream  upon  the  anti-cathode  placed  in  the  exact  focus  when  used 
with  very  strong  exciting  currents  is  very  great  and  it  is  always  advantageous 
to  the  life  of  a  tube  to  employ  some  device  for  limiting  the  excessive  develop- 
ment of  heat.  The  simplest  of  these  is  the  use  of  heavy  discharge  targets, 
which  consist  (A  a  mass  of  metal  faced  with  platinum,  having  a  large  thermal 
capacity,  tin-  lulmlar  projection  being  often  blackened  to  facilitate  the  radia- 
tion  of   lu-at    irciin   the   target.       Such   a   tube   is   shown   in    Fig.   65.       It   is, 


48  RADIO-THERAPY 

however,  more  advnntageous  to  employ  in  conjunction  with  these  a  small 
porcelain  disc,  which  is  inserted  between  the  sheet  of  platinum  and  the 
tubular  shaft.  This  arrangement  answers  admirably,  and  the  life  of  the  tube 
is  much  prolonged  by  its  use.     The  "contrast"  tube,  shown  in  Fig.  66.  pos- 


FiG.  65.     Heavy  Anode  Regulating  Tube.      (ScIialL   London.) 


sesses  all  these  advantages.  Another  method  of  obviating  the  difficulty  is 
by  using  water-cooled  tubes,  either  by  means  of  a  water  circulation  or  by 
making  the  anti-cathode  hollow  and  filling  it  with  a  quantity  of  water,  with  a 
provision  for  the  escape  of  the  steam  generated  in  working.  The  detrimental 
efifects  of  the  closing  spark  upon  focus  tubes  when  currents  of  high  voltage 
are  employed  on  the  primary  of  the  coil  has  lately  been  remedied  by  the 
introduction  of  "valve"  tubes,  which  are  inserted  m  series  with  the  tube. 
The  additional  outlay  this  involves  is  counterbalanced  by  the  saving  effected 
in  the  increased  length  of  life  of  the  focus  tubes. 

FLUOROSCOPES    AND    FLUORESCENT    SCREENS.— The    only 
two  of  the  many  salts  that  fluoresce  under  the  action  of  the  X-rays  that  are 


Fig.  66. 


Water-Cooled    Contrast 
(Iscntlml,    London.) 


Tube. 


1  K,    (jj      Lollap^ibk   Ci\ptoscope. 
(H.   IV.  Cox,  Ltd.,  London.) 


employed  in  the  manufacture  of  fluorescent  screens  are  Barium  platino- 
cyanide  and  Calcium  tungstate.  The  fluorescence  of  the  former  is  a  brilliant 
yellowish  green;  that  of  the  latter  is  bluish-white  and  not  so  intense;  but  on 
account  of  its  colour,  it  possesses  a  greater  photo-chemical  activity,  and  is 
therefore  used  as  an  intensifying  screen  for  radiographic  work.  In  the 
screens  of  English  makes  the  barium  crystals  are  larger  and  more  thickly 
spread;  in  those  manufactured  on  the  Continent  the  coating  is  more  evenly 
spread. 

A  cryptoscope  is  a  close-fitting  box.  intended  to  shut  out  all  extraneous 
light  from  the  screen.     It  is  sometimes  fitted  with  accordion  folds   (Fig.  67), 


XOTHS  OX  IXSTRUMENTATION 


49 


which  allow  tlie  cU-tance  between  the  eye  and  screen  to  be  adjusted;  but  the 
advantage  does  not  compensate  for  the  increased  cost. 

INTENSIFYING  SCREENS.— The  fogged  appearance  of  nega- 
tives obtained  by  radiographic  exposures,  more  especially  of  those  through 
the  thicker  parts  of  the  body,  is  due,  according  to  Villard.  to  the  fluorescence 
of    the    surrounding    air.     Of    all    the    various    attempts    to    prevent    this    by 


Fig.  69.     Bunsen   Stand   Tube   Holder. 
(//.   W.  Cox,  Ltd.,  London.) 


Fig.  68.     Tube  Holder,  with   l'>all  W'ciglu 
{Watson  &  Sons,  London.) 


.r^t:^ 


Vu,.  70.     Telescopic  Tube  il.ildiT.      {Dran,  London.) 


50 


RADIO-THERAPY 


accelerating  and  intensifying  the  effects  of  the  rays  upon  the  sensitized  iihri, 
the  only  method  that  has  hitherto  been  attended  with  any  measure  of  success 
is  the  use  of  certain  substances  which  fluoresce  when  excited  by  the  X-rays 
and  act  upon  the  sensitized  film  like  ordinary  light.  Owing  to  the  granular 
state  of  the  fluorescent  screen,  the  resulting  radiograms  somewhat  lack 
definition,  so  that  minor  details,  especially  of  the  smaller  osseous  structures, 
are  effaced.  If  a  platino-cyanide  of  barium  screen  be  employed  for  this  purpose, 
the  photo-films  must  first  be  colour-sensitized  by  treatment  with  a  .01%  solu- 
tion of  erythrosine  and  drying  in  a  perfectly  anactinic  chamber.  In  taking 
radiograms  by  this  method,  the  intensifying  screen  is  placed  immediately 
above  the  film  or  plate,  so  that  the  rays  must  pass  through  it  before  they 
can  act  upon  the  plate. 

The  substitution  of  amorphous  calcium  tungstate  for  the  granular 
platino-cyanide  in  the  preparation  of  the  screen  has  allowed  better  skia- 
graphs to  be  obtained  with  ordinary  dry  nlates.  In  using  such  a  screen 
the  coated  surface  is  placed  in  contact  with  the  emulsion  of  the  plate  or  film, 
which  is  placed  nearest  to  the  object  to  be  radiographed.  By  combining  the 
two  methods,  Max  Levy  has  been  able  to  greatly  mtensify  the  eft'ects  and 
proportionately  shorten  the  duration  of  exposure.  He  employs  a  plate  or 
film,  coated  on  both  surfaces  with  a  sensitive  emulsion,  and  placed  between 
two  intensifying  screens.  As  contact  with  these  gives  double  density  to  the 
negative  the  time  of  exposure  is  materiallv  shortened. 

TUBE  HOLDERS  (Figs.  68.  69  and  70).— Although  for  experimental 
work  the  ordinary  Bunsen  retort  holder  with  heavily  weighted  base  allows 
of  the  tube  being  fixed  in  any  desired  position,  still,  for  clinical  purposes,  we 
require  a  stand  which  will  enable  us  to  fix  the  tube  at  any  height  from  the 
floor,  and  allow  it  to  project  far  enough  from  its  support  to  be  brought  oyer 
the  operating  table  or  couch.  For  this  purpose  a  stand  with  a  heavily 
weighted  base  and  firmly- clamped  projecting  arm  with  swivel  and  ball  joint 
is  necessary.  The  projecting  arm,  which  carries  the  tube  and  the  connecting 
wires  is  always  made  of  wood  or  ebonite,  to  prevent  any  spark  from  the 
terminals,  in  passing  into  the  metal,  perforating  the  tube. 


A 


B 


Fig.  71.     High-Frequency   Couch.      (II.    //'.    Cox,   Ltd.,    London.) 


For  use  with  overhead  coils,  and  in  offices  where  the  amount  of  floor 
space  is  limited,  the  "WALL  BRACKET"  type  of  tube-holder  will  be  found 
very  convenient;  while  for  portable  installations  a  telescopic  tube-holder  is 
almost  indispensable. 

COUCHES  (Figs.  71  and  72). — Whenever  radiograms  have  to  be  taken 
of  a  patient  in  the  recumbent  position,  a  radiographic  couch  will  prove  a  very 


XOTES  OX  IXSTRUMEXTATJON 


51 


Useful  accessory.  It  essent-ally  consists  of  a  strong  wooden  framework, 
over  the  top  of  which  a  sheet  of  canvas,  thin  leather  or  other  material 
radioscopically  transparent  is  stretched.  By  placing  the  tube  below  the 
couch,  the  patient  can  easily  be  examined  with  the  fluorescent  screen.  In 
taking  radiograms,  a  photographic  plate  is  placed  below  the  screen,  and  the 
tube  brought  as  close  to  the  bodv  as  is  considered  advisable.     Couches  fitted 


Fig.  72.     Mackenzie  Davidson   Couch.     (//.    JV.   Cox,  Ltd.,  London.) 


with  a  plate-holder  which  can  be  brought  in  contact  with  the  part  to  be 
radiographed  allows  the  radiographer  to  operate  to  the  best  advantage;  as 
once  the  object  is  fixed  with  the  fluoroscopic  screen,  no  change  in  the  position 
of  the  patient  or  tube  is  necessary  to  obtain  a  good  skiagraph. 

Some  couches  are  especially  designed  for  localisation  and  stereoscopic 
radiography.  In  these  the  tube  holder  and  plate-rest  (although  adjustable) 
are  permanently  connected  with  each  other  in  order  to  maintain  a  certain  fixed 
relation  between  the  tube  and  object.  The  plate-holder  is  so  constructed  that 
the  plates  may  be  changed  without  disturbing  the  patient  or  causing  him 
to  alter  his  position,  and  the  holder  possesses  cross  and  orientation  wires, 
while  both  tube  and  plate-holder  move  simultaneously  so  as  to  bring  the 
latter    in    relation    to   the   particular    part    of   the   body    to   be    radiographed. 

STEREOSCOPIC  RADIOGRAPHY  (Figs.  73.  74  and  75)-— 
Drs.  Hcdlcy,  Mackenzie  Davidson.  Imbcrt  and  Bcrtin-Sanis  have  shown  that 
two  radiograms  taken  with  tubes  2^4  inches  apart,  when  suitably  mounted 
and  viewed  in  a  stereoscope,  will  give  an  object  in  proper  relief.  Radio- 
graphic stereograms,  however,  differ  from  ordinary  stereograms  in  as  much 
as  it  is  immaterial  which  picture  is  mounted  on  the  right  or  left-hand  side 
of  the  stereoscope,  as  the  change  only  produces  a  difference  of  aspect 
(i.e.,  gives  the  anterior  or  posterior  view).  In  order  to  see  objects  in  stereo- 
scopic relief  on  the  fluorescent  screen,  two  tubes  must  be  placed  with  their 
target  2^  inches  apart.  =0  that  the  distance  between  them  is  equal  to  the 
distance  between  the  eyes.  When,  by  means  of  a  commutator,  the  discharge 
from  an  Induction  Coil  is  alternately  directed  into  one  or  other  of  these, 
whilst  the  operator  looking  through  two  openings  in  a  screen  fitted  with  a 
disc  sector,  which  allows  the  eyes  to  be  illuminated  synchronously  with  the 
alternations  of  the  discharge   in   the  two  tubes,   the  object   viewed   ceases  to 


52 


RADIO-THERAPY 


appear  as  a  flat  shadow  and  stands  out  as  an  image  which  conveys  the  sense 
of  actuality  and  relief.  It  is,  of  course,  essential  to  the  success  of  these 
experiments  that  the  two  tubes  should  have  the  same  penetration,  so  as  to 
excite  the  same  degree  of  fluorescence  in  the  screen.  The  trouble  is  to  find 
two  such  tubes,  and  although  the  difficulty  has  been  partially  solved  by  the 
use  of  two  bulbs  with  a  medium  of  communication  between  them,  it  is  not 
always  possible  in  working  with  these  to  prevent  the  active  tube  sparking 
across  to  the  inert,  and  thus  confuse  the  shadows.  We  are  therefore 
restricted  to  the  use  of  soft  tubes  of  comparatively  little  penetration,  which 
correspondingly  diminishes  the  fluoroscopic  shadow  effects.  It  must,  how- 
ever, be  admitted  that  stereoscopic  radiography  promises,  when  development 
is  sufficiently  advanced,  to  be  the  easiest  exact  method  of  localisation. 


Fig.  72-    Stroboscope. 
(Schall,  London.) 


Fig.  74.     Stroboscope,   Double  Tube.      {Scliall,  London.) 


DEVICES  FOR  RESTRICTING  THE  EFFECTS  OF  THE  RAYS 
TO  PARTICULAR  AREAS.— The  two  chief  devices  employed  for  this 
purpose  are  ADJUSTABLE  DIAPHRAGMS  and  TUBE  BOXES. 

Adjustable  Diaphragms.  These  consist  of  a  skeleton  frame,  to  which 
can  be  fitted,  according  to  the  needs  of  the  moment,  metallic  diaphragms  of 
sheet  lead,  or  of  some  other  equally  opaque  metal,  with  a  central  aperture  of 
the  required  size.  This  framework  is  usually  permanently  connected  with  the 
tube-holder.  Among  later  models  we  notice  diaphragms  in  which  the  size  of 
the  aperture  can  be  increased  or  diminished  by  removing  or  affixing  ring- 
slips,  and  others  in  which  this  is  effected  by  adjustment  of  the  iris  diaphragm. 

Tube  Boxes  (Fig.  76).- — These  are  made  of  wood  and  lined  with 
several  layers  of  lead-foil  similar  to  that  used  for  lining  tea-chests.  The  interior 
is  insulated  against  sparking  by  a  thick  padding  of  felt.  This  arrangement 
practically  prevents  the  rays  from  passing  out  except  through  a  circular 
aperture,  3  inches  in  diameter,  made  in  one  side  of  the  box.  The  size  of  the 
aperture  can  be  further  reduced  by  means  of  diaphragms  of  heavy  sheet- 
lead.     In  order  to  prevent  sparking  from  the  lead  plate  a  diaphragm  of  plate- 


XOTHS  OX  IXSTRCMEXTATIOX 


53 


glass  is  also  inserted.     In  -^oino  models,  instead  of  using  leatl-foil.  the  interior 
of  the  box  is  coated  with   so\eral  layers  of  lead-paint.     The  size  of  the  box 


"BC^i 


Fig.  75.     Commutator.     {Scluill.    1..  .mlon.) 


varies  in  the  models  of  different  makers,  some  being  unnecessarily  large  and 
cumbersome,  while  others  arc  too  small  to  secure  perfect  insulation.  Attempts 


l""i(j.  76.    Bracket  Tube- Box.      (.!>\7/(i//,  London. ) 


54 


RADIO-THERAPY 


have  also  been  made  by  mechanical  means  to  allow  the  position  of  the  box 
being  altered ;  but  for  use  with  the  exploration  couch  the  simpler  models  are 
the  most  efficient.  These,  when  used  for  therapeutic  applications  to  the  face, 
require  to  be  mounted  on  a  pedestal  or  attached  to  a  wall-bracket. 

MASKS.  —  These  protections  are  made  of  either  lead  plates  and 
covered  with  flannel  or  paraffined  paper,  or  they  are  made  of  gauze  or  gutta- 
percha, moulded  while  warm  to  the  shape  of  the  part  and  covered  with  tinfoil. 
The  edge  of  the  holes  cut  into  them  being  covered  over  with  a  layer  of 
paraffinated  or  shellacked  paper.  In  makmg  exposures  in  the  mouth,  pharynx 
or  vagina,  a  speculum  of  block  tin  can  easily  be  improvised.  The  use  of 
adhesive  plaster  and  of  ointments  made  of  bismuth  and  zinc  is  only  advisable 
when  it  is  impossible  bv  any  other  means  to  protect  the  tissues  against  burns. 

PROTECTIVE  SCREENS.— These,  in  accordance  with  Elihu  Thom- 
son's directions,  are  made  of  aluminium  and  earthed.     They  appear  to  absorb 


Fig.  77 .    The  Apparatus  of  Lortet  &  Genoud.     (iVatson  &  Sons,  London.) 


the  softest  rays,  which  exert  the  greatest  influence  upon  the  skin  {i.e.,  setting 
up  a  dermatitis)  without  affecting  the  more  penetrative  radiations. 

APPARATUS  USED  IN  TREATMENT  BY  CONCENTRATED 
CHEMICAL  LIGHT. — In  order  to  intensify  the  bactericidal  effect  of  the 
solar  rays  and  render  them  therapeutically  effective,  lenses  and  mirrors,  which 
concentrate  the  rays  and  bring  them  to  the  definite  focus  are  used.  The  appa- 
ratus which  is  the  more  often  employed  is  a  hollow  bi-convex  lens,  filled  with 
a  solution  of  methylene  blue  or  ammoniated  sulphate  of  copper,  so  as  to 
occlude  the  greater  number  of  heat-rays. 

The  amount  of  sunlight  available  for  use  in  northern  latitudes  being 
very  limited,  it  has  been  thought  necessary  to  supply  the  deficiency  by  having 
recourse  to  artificial  illumination.  The  light  best  fitted  for  this  purpose  is  the 
voltaic  arc,  for  that  given  out  by  incandescent  lamps  contains  too  few  chemical 
ravs. 


NOTES  OX  IXSTRLMtXTATION 


55 


As  the  rays  from  an  arc  lamp  are  divergent,  special  apparatus  em- 
ployed must  be  provided  for  rendering  them  parallel  before  passing  through 
the  hollow  lens  which  focuses  them  upon  the  part  to  be  treated.  The  appa- 
ratus employed  for  this  purpo-^e  consists  of  two  cylindrical  telescopic  tubes, 
fitted  with  plano-convex  lenses  for  rendering  the  rays  parallel  (the  space 
between  them  being  usually  provided  with  a  water-circulation)  ;  and  the 
hollow  bi-convex  lens  already  described  for  focusing  the  rays  on  the  part. 
This  extension  piece  of  the  Finsen  Lamp  is  mounted  upon  the  metallic  support 
of  the  lamp.  In  order  to  render  bloodless  the  regions  submitted  to  the 
action  of  the  light,  a  compressor  apparatus,  which  essentially  consists  of  a 
slightly  convex  plate  of  glass  set  in  a  metallic  frame,  is  employed.  This  is 
held  in  position  by  elastic  bands  or  by  being  pressed  firmly  over  the  part  to  be 
treated. 

THE  FINSEN  ARC-LAMP  consists  of  an  arc  lamp  of  60  to  80 
amperes,  in  which  the  positive  carbon  is  placed  above  the  negative,  so  that  the 
rays,  in  passing  from  the  crater,  are  projected  downward  and  outward.     In 

„SANITAS"  ELECTRICAL  COMPANy 
LONDON.W.  75   Soho Square, 


£rv^ 


Fig.  78.     Dermo  Lamps.      (Sanitas  Electrical  C"  .   Lnndun.) 


the  axis  of  the  rays  issuing  from  the  luminous  point  are  four  copper  tele- 
scopic tubes  of  the  kind  already  described,  the  lenses  of  which  are  made  of 
rock-crystal  so  as  not  to  intercept  the  chemical  rays,  each  one  being  provided 
with  a  w-ater  circulation  for  cooling  the  ravs  as  thcv  pass  out. 

THE  APPARATUS  OF  LORTET  AND  GENOUD  (Fig.  77)— In 
it  the  arc-light  employed  is  feebler  than  in  the  Finsen,  and  consumes  only  10 
to    20    amperes.     The    carbons    are    inclinc(l    towards    one    another.      It    also 


56 


RADIO-THERAPY 


possesses  a  water  circulation.  The  distal  end  of  the  screen  is  fitted  with  a 
compressor  lens  identical  with  that  of  the  Finsen  lamp.  As  the  arc  is  brought 
quite  close  to  the  patient,  the  amount  of  light  wasted  is  greatly  diminished; 
so  that  a  much  larger  area  of  skin  can  be  efficiently  treated  at  each  sitting 
whose  duration  is  at  the  same  time  considerably  reduced. 

THE  APPARATUS  OF  DR.  SCHALL.— This  was  intended  to  allow 
operators  working  off  the  alternating  commercial  mains  to  enjoy  the  same 
advantages  as  those  using  a  continuous  current.  This  apparatus  can  also  be 
used  on  the  continuous  current  supply.  In  working  off  a  continuous  current 
the  crater-like  depression  formed  in  the  negative  carbon  prevents  diffusion  of 
the  luminous  rays ;  but  in  use  on  alternating  current  mains  both  carbons  are 
pointed,  so  that  the  light  is  dispersed  equally  in  all  directions.  To  prevent 
loss  from  this  dispersion.  Dr.  Schall  has  introduced  a  reflector  that  can 
withstand  the  very  high  temperature  of  the  arc.  It  consists  of  a  disc  of  fine 
clay,  into  whose  mass  some  oxide  of  magnesium  has  been  incorporated. 
One  side  of  the  disc  is  hollowed  out  so  as  to  form  a  cylindrical  cavity,  in 
which  the  points  of  the  carbons  protrude.  A  refractor  that  can  be  adjusted 
by  means  of  a  milled  screw  regulates  the  distance  between  the  two  carbon 
points,  while  the  intercalation  of  a  third  carbon  between  these  establishes 
the  arc.     It  consumes  a  current  of  8  to  lo  amperes  at  50  to  60  volts. 

THE  DERMO  LAMP  OF  DR.  BANG.— As  the  amount  of  ultra-violet 
rays  depends  on  the  chemical  composition  of  the  substance  of  which  the  elec- 
trodes are  composed,  several  attempts  have  been  made  to  turn  this  factor  to 


Fig.  80.     Triplet  Lamp.      (Saiiitas 
Elcctl.    Co.,   London.) 


Fig.  Si.     Spark  Lamp.     (H.  IV.  Cox, 
Ltd.,   London.) 


account.  Strehcl  has  experimented  with  electrodes  of  magnesium  oxide, 
aluminium  oxide  and  zircone.  He  has  also  made  use  of  aluminium  elec- 
trodes. 

Righi  has  demonstrated  that  the  electric  arc  passing  between  a  positive 
electrode  of  zinc  and  a  negative  electrode  of  carbon  produces  purer  chemical 


NOTES  OX  IXSTRUMEXTATION 


57 


rays  than  the  ordinary  arc :  but  it  was  Bang,  the  director  of  the  Finsen 
Institute,  \vho  first  succeeded  in  constructing  a  lamp  with  metallic  electrodes 
suitable  for  phototherapy.  This  lamp  is  intended  to  yield  a  maximum  of 
chemical  rays,  with  a  minimum  production  of  heat ;  by  using  iron  for  the  elec- 
trodes, and  reducing  their  heat  resistance  bj-  a  water  circulation.  For  large 
lamps  the  whole  of  the  electrode  except  the  tip  is  cooled  by  being  plunged 
in  a  container  filled  with  water.  This  lamp  is  only  suitable  for  the  treatment 
of  superficial  cutaneous  affections,  as  the  rays  possess  no  powers  of  deep 
penetration,  but  expend  their  whole  energv  on  the  cuticle. 

THE  APPARATUS  OF  BROCHA  &  CHATIN.— It  resembles  the 
Bang  Lamp  in  the  use  of  metallic  electrodes,  but  differs  from  it  in  possessing 
no  refrigeration  apparatus.     It  consumes  much  more  current.     The  electrodes 


Fig.  82.     Light    Bath,    with    Search-light.      (Scluill.    London,) 


consist  of  a  positive  electrode  of  carbon  with  an  iron  core  and  an  ordinary 
carbon  negative  electrode.  It  is  fitted  w-ith  an  automatic  regulator  and  a 
metal  screen  for  protecting  the  operator  from  the  chemical  effects  of  the 
light.  It  has  four  telescopic  tubes,  three  of  which  are  intended  for  treating 
patients,  the  fourth  for  viewing  the  carlions.  It  consumes  15  to  20  amperes. 
Owing  to  the  absence  of  a  water-cooling  arrangement,  one  has,  in  using  it, 
to  rely  on  very  energetic  compression  (while  keeping  the  patient  3  or  4  inches 
from  the  arc)  to  prevent  burns. 

THE  FINSEN-REYN  LAMP.— This  apparatus  also  combines  the 
advantage  of  the  Bang  I^mp  with  the  original  F^insen  arc.  Constructed  on 
similar  lines  to  the  Lortet-Genoud  lamp,  it  produces  better  results,  as  one 
increases  the  amount  of  ultra-violet  rays  by  the  use  of  an  iron  core   fur  the 


positive  electrode.     It  requires  to  be  used  with  a  cinnpres'^or  lens. 

THE    TRIPLET    LAMP    (Fig.    80).— This    is    distinguished 


the 


58 


RADIO-THERAPY 


following  features:  It  allows  of  carbon  and  iron  electrodes  to  be  used  either 
separately  or  together,  so  as  to  produce  a  mixed  light;  so  that  it  is  equally 
applicable  for  the  treatment  of  superficial  and  deep  skin  affections. 

THE    STREBEL    LAMP.— This    is    fitted    with    two   positive    carbon 


Fig.  83.     Local  Light  Baths.     (.W'atsun  &  Sons,  London.) 


electrodes  with  iron  cores,  and  two  ordinary  carbon  negatives,  and  is  pro- 
vided with  a  refiector  of  magnalium,  a  rock-crystal  lens  and  a  water-cooling 
arrangement.  It  can  be  used  for  both  deep  and  superficial  diseases  of  the 
cutis. 

THE   SPARK  LAMP    (Fig.  8r).— This   apparatus  makes  use  of  the 

r& 


Fig.  84.     Search   Light.     {Schall,   London.) 


oscillatory  discharge  of  a  condenser  as  a  source  of  ultra-violet  radiations. 
The  electrodes  are  of  metal  enclosed  in  a  circular  ebonite  case,  which  is 
fronted  bv  a  compression  lens  of  quartz. 

LIGHT  BATHS    (Figs.  82  and  8.3).— The  use  of  light  baths  for  the 


NOTES  OX  IXSTRUMEXTATIOX 


59 


treatment  of  diseases  has  of  recent  years  attracted  some  attention.  Their 
therapeutical  effects  differ  according  to  the  source  of  light-rays.  A  bath 
fitted  with  incandescent  lamps  produces  heating  effects  alone ;  while  those 
supplied  with  arc-lamps  in  addition  supply  the  more  chemically  potent  ultra- 
violet radiations.  A  bath  of  this  nature  is  shown  in  Fig.  82.  In  this  model 
the  window  is  provided  to  allow  the  light  from  a  powerful  search-light  to  play 
upon  the  body  of  the  patient.  To  prevent  the  skin  being  scorched,  the  rays 
are  made  to  pass  through  a  filtering  screen  of  spectroscopically  tested  blue 
glass,  cut  into  narrow  strips  to  allow  them  to  expand  under  the  influence  of 
the  heat  without  breaking. 

THE  KAISER  LIGHT  TREATMENT  (Fig.  84).— Dr.  G.  Kaiser  of 
Vienna  has  found  that  the  blue  and  violet  rays  of  the  spectrum  produce  only 
a  slight  inflammation,  and  in  consequence  of  this  both  circulation  and 
metabolism  are  stimulated.  The  apparatus  tised  consists  of  a  powerful  search- 


Fic.s.  85  and  86.     Radium   Ai)i)licaliir>.    i^U\itsoii   &  Sons,   London.) 


light  with  magnaiium  reflector,  a  blue  light-fiiter  of  spectroscopically  tested 
glass  cut  into  narrow  strips  to  prevent  fracture  from  unequal  expansion, 
and  a  hollow  lens  filled  with  a  solution  of  methyline  blue  to  which  a  small 
quantity  of  alum  has  been  added.  The  light  consumes  a  current  of  16  am- 
peres at  55  volts. 

RADIUM  THERAPY  (Fig.s.  8.5  and  86).— In  the  experimental  appli- 
cations of  radium  to  diseased  structures,  the  metallic  salt  is  enclosed  in  a 
container  like  that  shown  in  the  accompanying  woodcut  (Fig.  85).  The 
second  applicator  is  intended  for  making  applications  to  the  tongue  (Fig.  86). 


ISENTHAL  &  Co. 


85  Mortimer  Street,  London,  W. 


The  most   PERFECT  and    EFFICIENT 

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WATSON'S    HEAVY    DISCHARGE   INDUCTION    COILS 

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For  Neurasthenia,  Rheumatism,  etc. 

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"THE  SCinXCE  OF  THE  SUyBEAAl." 

THE   DOWSING 

Radiant  licat  and  Cigbt  treatment 

For  Rheumatism,  Gout,  Arthritis,  Lumbago,  Sciatica,  Sprain, 
Stiff  and  Painful  Joints,  and  many  Disorders  of  the  Digestive  Organs. 


Tlie  Dowsing  R;;di.int  Heat  and  I-iglit  Treatment  is  a  new  and  succcsslul  method  ot 
applying  Light  and  Heat  Rays  ot' great  intensity  to  the  limbs  and  parts  of  the  body. 

Tills  system  of  treatment  differs  from  all  so-called  hot-air  applications,  and  it  is 
claimed  that  greater  benefit  can  be  derived  from  the  Jiiccl  application  of  Luminous 
Heat  Rays,  wiiich  in  the  Dowsing  system  are  thrown  direct  upon  the  body.  Tiie 
physiological  action  of  the  Dowsing  Bath  shows  the  following  phenomena: — 

(i)  Very  marked  rediie.ss  in  the  skin.  (7)  ParlicuUrexcitation  of  llieskin  by  Ihecheniical 

U>  Very    abundant    skin    perspiration    and    the  rays  and  on  the  other  part  of  pronounced  bactericidal 

elimination  of  considerable   quantities   of  carbonic  properties. 

acid  by  the  lungs.  (8)  Special  action  of  the  Luminous  Rays  on  the 

(1)  Acceleration  of  the  pulse  and  increase  of  tem-  red  globules  of  tlie  blood,   the   number   of  which 

perature  of  the  subject  ;  these  two  phenomena  are  increases  the  oxygenation, 

less  marked  in  proportion  than  in  Turkish  baihs.  Radiant  Luminous  Heat  is  the  healing  vehicle,  par 

(4)  Increase  of  the  volume  of  solid  materials  of  excellence,   for  gout  and  rheumatism,  contusions, 

the  urine  and  urea,  and  less  uric  acid.  sprains,  etc.  ;  as  regards  arthritis,  very  bad   cases 

(St  Greater  activity   of  the   functions  of  general  have  been  cured  by  continued  baths, 

nutrition,  and  the  elimination  of  organic  oxidation  FINALLY,    among    general    affections,  such   as 

products.  arthritis,  obesity,  anceinic  and  general  debility,  all 

(6)  Penetrating  power  of  the  heat  rays  much  more  are  happily  influenced  by  the  action  of  Luminous 

than  that  of  obscure  heat.  KadanlHeM.-  I.e  Doclcui  C>iiycnot{<i'  Aixh-sH,ihis). 

The  following  are  some  opinions  of  leading-  English  Medical  Men:— 

"  In  the  Radiant  Heat  Electric  Heat  Baths  we  have  an  agent  which,  while  supplying 
all  the  advantages  of  other  forms  of  heat  baths,  possesses  something  more,  namely,  the 
luminous  rays.  By  their  use  we  may  derive  much  of  the  benefit  of  sunshine  as  com- 
pared to  that  of  other  modes  of  heating." 

"  If  one  considers  tor  a  moment  the  remarkable  effects  which  can  be  produced  by 
sun  baths,  it  is  forced  upon  the  mind  that  in  the  luminous  rays  there  are  probably 
therapeutical  effects  not  possessed  by  the  non-luminous." 

"  I  consider  the  ideal  source  of  heat  for  such  a  purpose  is  a  luminous  one." 

"  The  necessity  of  the  human  body  for  light  and  air  is  of  universal  recognition,  people 
become  aniumic  when  deprived  of  light.  .  .  .  There  are  some  special  therapeutic 
properties  in  radiant  heat." 

The  Dowsing  Apparatus  is  fully  protected  by  a  number  of  important  patents,  and  the 
Radiant  Heat  Treatment  Is  registered.  The  apparatus  is  supplied  only  for  use  by  Medical 
Men,  or  Institutions.  Hospitals,  Sursing  Homes,  &c.,  under  their  care.  We  have  no  agents, 
and  the  apparatus  is  not  sold;  the  object  being  to  prevent  it  falling  into  unqualified  hands. 

The  Profession  is  warned  against  copies  and  infringements  offered  as  similar  to  the 
Dowsing  System,  the  apparatus  so  made  having  no  therapeutic  value  whatever. 

J'jiiiplilcis,  uilli  cxtijcls  fioni  Mi'ilical  Joiinulf,  coiiljiiiiin^ Jiill  p.iiticiiljis  0/  the 
svstem,  free  on  application  to 

THE  DOWSING  RADIANT  HEAT  CO.,  LTD. 

Registered  Office:  24  BUDGE  ROW,  CANNON  SIRIiET,  E.C. 

I'hr   <'onip,iitr\   Chir/'  l:sl,ihli^hi>i,-iit^  n, f  : 

LONDON,  28  York  Place,  Baker  Street,  W.  BATH,  5  Oxford  Row. 

BOURNEMOUTH,  Glen  Fern  Gardens. 

The   Trciilnifiit  may  also  be  oblaiiifil  at  the  following   Towns  : 

IUtm.   ISouHsRMoijiii,   Bai.ham,   Bakmouim,   Belfast,   Bkxiiii.i.,   Bikmingiiam,    Hradkord,    Ukistoi  ,    Hkomiey, 

Bi;xTos,  ('amhhidch,  ("anthbbury.  ('hi-.lska,  C.iieitknmam,  (".okk,  Oovdon,  Dublin.  Dunhlanh,  Kastbournk, 

KniNHUROII,    lixF.TLR,    KXMOIJIH,    GLASGOW,     tlASTINGS,    HaRROCATH,    lluil,    I  EAMINGTON,     Lf.BDS,      l.lVHRPOOl, 

l.i.ANDKiNiiou  Wkli.s,  I.YMiNcroN,  M ANCMc.sTKR.  Matloc.k,  Ni-wcastlk,  Norwicii,  Norwood,  Nottingham, 
f)ir)MAM,  OxKORij.  Plymouth,  Rkijiiili  ,  Rydh,  St.  Leonards,  Scarhorougii,  Smanklin.  Siiki  hei  »,  Soutiiport, 
ToRauAY,  Tunbriijoe  Wllls,  UrTER  Norwoou,  Ventnor,  Virginia  Water,  West  Kirby,  Woouiiall  Spa, 
Yar.moutii,  York. 


Installation  of  X-Ray  and  High-Frequency 
Apparatus,  showing  Switch-table  from  which  every- 
thing IS  controlled,  and  apparatus  for  Magneto 
1  heraphy. 

Total  price  about  £150. 


Installation  for  Sinusoidal  by  Dr.  Smith. 
Galvanic  and  Faradic  Water  Baths.  Static  Machine 
and  Vibrator  for  Massage. 

Total  price  about  £100. 


Electrical  Co. 
Ltd. 

7a  SOHO  SQUARE 
LONDON,  W. 

MAK[!|  AlVUIKFKh  OH 

Cniiplete  Installations  of 
apparatus  for  all  modern 
methods  of  treatment,  by 
Lisht,  Heat,  Electricity 
and  Physical  Exercise, 
etc. 


Electrical  Co., 
Ltd. 

ra  SOHO  SQUARE 

LONDON,  W. 

The  whole  of  our  appli- 
ances may  be  inspected 
in  working  order  in  our 
Showroom. 

Spn-hi/  Cn/,i/ngiies  ami 
detailed  inlonnation  on 
application. 

Installation  of  Apparatus  for  Physical  Exercise.  "  Sano "  for  Rowing,  Hill  Climbing,  Pulling, 
etc.,  etc.  Velotrot  for  the  motion  of  Cycling  and  Horse-riding  (combined  or  otherwise)  with  the 
attendant  highly  beneficial  vibration  o(  the  whole  body  :  and  four  other  practical  appliances  for  different 
purposes.  .r-.._.    ...  .'._--,_- 


Total  price  about  £55.15.0 


5^sJ      t- 


Installation  for  the  treatment  of  Skin  Diseases 
by  the  carbon  and  iron  light  of  the  "  Dermo  "  and 
"Triplet"  Lamps  and  "Combined"  Projector. 
Also  Switchboard  for  Cautery,  Galvanisation, 
Faradisation,  Electrolysis,  Cataphoresis,  etc. 

Total  price  about  £150.0.0 


Installation  for  Light  Bath  treatment  by  "Com- 
bined" double  Light  Baih  with  Arcand  Incandescent 
Lamps,  and  with  Projector  for  additional  illumination 
from  outside  of  actual  seat  of  complaint.  Portable 
Light  Baths  for  local  treatment  of  Trunk  or  Lime 
and  Bidet  for  treatment  of  female  diseases  by  light. 

Total  price  about  £125.0.0 


The  various  appliances  referred  to  are  fully  protected  by  Patents  In  the  United  Kingdom 
and  in  many  foreign  countries. 


IMPORTANT  ANNOUNCEMENT 

JACOBI— A  Portfolio  of  Dermochromes.  By  Professor 
Dr.  Jacobi,  of  Freilnirg.  Only  Edition  aiitliorized  to 
be  publislied  in  the  Englisli  language.  The  text  trans- 
lated and  adapted  by  J.  J.  Pkingle,  M  B.,  F.R.C.P., 
Physician  to  the  Department  for  Diseases  of  tlie  Skin 
at  the  Middlesex  Hospital,  London. 

This  work  contains  plates  of  Dermocliiomes  beautiruliy  reproiiuceil 
in  natural  tints  bv  a  new  Foun-Coi  oik.Pro<:kss.  illustrating  the  Common 

Diseases  of  the  Skin  and  Venereal  Affections  which  the  Gener.il 
Practitioner  has  frequent  opportunities  of  observing  in  his  daily  practice. 
Each  plate  is  accompanied  by  a  page  or  more  of  explanatory  text  contain- 
ing practical  points  in  treatment. 

The  work,  complete  in  two  volumes,  is  published  at  the  very 
moderate  subscription  price  of  $15.00  in  half  leather;  $16.00  in  full 
flexible  leather  with  gilt  edges,  thus  bringing  it  within  reach  of  all 
General  Practitioners  and  Students.     Sold  only  hy  mhicriplion. 

A  Pinspccliis  Liiul  Specimen  Plate  zcill  be  sent  on  receipt  of  card. 

"  Charm  of  novelty  .  .  .  accurate  delineations  .  .  .  faith- 
ful and  lifelike  portrayal  of  flesh  Unts."— Journal  0/  Ciiniiteous  Diicascs. 

"Happiest  results  we  have  seen  .  .  .  Difficult  to  imagine  a 
more  useful  atlas.'" — London  Lancet. 

"  Remarkable  plates  .  .  .  Nothing  could  exceed  the  skill  with 
which  these  plates  are  reproduced  !  " — Medicine. 

"Surpassing  in  every  respect  anything  that  has  previously  fallen 
under  our  notice." — Nezv  York  Medical  Journal. 

"We  have  never  seen  their  equal."— Ca«<ii//<j;;  Practitioner. 

"Too  much  praise  cannot  be  bestowed  upon  them." 

— American  Medicine. 

"  Finest  plates  ever  seen  in  any  work  on  skin  diseases." 

— California  Medical  Journal. 


WILLIAMS— Hig-h  Frequency  Currents  in  the  Treat- 
ment of  Some  Diseases.  By  Chlmioim  W'u.lia.ms, 
F.R.C.S.,  Hdin.,  etc.  Electro-therapeutist  to  the 
West  London  Hospital,  etc.  Medium  8vo,  n-j.S  pages, 
with  7s  illustrations.     Price,  $2.75. 

"It  is  wilh  great  pleasure  that  we  welcome  the  first  systematic 
treatise  in  the  Knglish  language  on  the  electric  currents  of  higji  frequency, 
or  more  specially  the  high  frequency  currents  of  d'Arsonval." 

— Neu>  Yoik  Medical  Journal. 

NEW  YORK  LONDON 

REBMAN  COMPANY  KEBMAN  LIMITHI) 

10  West  230  Stkef.t  129  Shaktesburv  Ave. 


WAITE  &  BARTLETT  MFG.  CO. 

217  East  23d  Street,  New  York,  U.  S.  A. 


HIGH-GRADE   ELECTRO-MEDICAL  APPARATUS 


Static  Machine 
X=Ray  Coil 


Piffard's  Higli-I  requency  Apparatus 

Piffard'sLIItra=Violet  Ray  Lamp 

Piffard's  Hand  Arc  Lamp 

Galvanic  and  Faradic  Switch  Boards  for  Commercial  Currents, 
Alternating  or  Direct 


SEND     FOR     CATALOGUE 


SPARK     C0IL5 

for  coiitiiuioiis-ciuieiU  willi  \;uiable    selt-iiKlikiiuii  hn    ;iny  tension  up  to  2=,o  volts. 


SWITCHING  AND  MEASURING  TABLES 

witli  i.';isL\l-in  W'ehiU'll-lnteniiplci. 
SWITCH-BOARDS  for  use  witli  interrupters 
liaving  sever. il  contact    pins  or  rotary 
interrupters. 

ROENTGEN-INSTALLATIONS  for  Mili- 
tary home  and  lieKI  liospitaN  (i'lie 
Koentiien-installations  in  all  the  hos- 
pitals of  Sa.xony  and  a  .great  number 
of  the  l^riissiaii  hospitals  aie  supplied 
from  my  works). 

ALL  APPARATUS  and  installations  for 
Kadio-therapy. 

STATIC-MACHINES  foi  medical  purposes, 


NEW  !  hitensity  siiades  and  protective 
spectacles  fitted  with  lead  glass;  a  pre- 
ventive against  the  bad  effects  of  the 
Roentgen  rays. 

ACCESSORY  apparatus  Km  all  puiposes. 

HARDNESS-MEASURE  for  determining 
the   hardness  ol'  tubes. 

CHROMORADIOMETER  for  dosage  in  the 
.\-l\.i\   treatment  ol  lupus. 

RADIUM-BROMIDE  chemically  pure, 
giving  astounding  results.  Hnclosed  in 
capsules.     Prices  on  application. 

etc.     Highest  efficiency  at  modeiate  prices. 


MAX   KOHL, 


CHEMNITZ, 
SAXONY. 


Estimates,    Directions  for    Use,    Refcicnccs. 
sent  free  on  applicatio)i. 


etc.. 


NOTICE!    Orders  can  be  executed  either   direct  or   througfh  the  Agency  ot 
Messrs.  Isenthal  &  Co.,  85  Mortimer  Street,  London,  W. 


PLECTRICAL  INSTRUMENTS 

FOR 

3uiTgieal  and  jYCedieal  7uf  poseSf 
jVCotof s,  X  ^ays,  Cight  gaths. 

New  Catalogue  of  over  200  pages  will  be  sent  free 
on  application  to — 

K.   SCHALL, 

35,  Great  Marylebone  Street,  LONDON,  W. 


The    First   and   ONLY   ORIGINAL   Journal   ever  published    on    X-Rays ! 


Annual  Subscription 
$4.00  in  Advance. 


PRICE,  36  CENTS  NET 
1  With  Postage,  40  cents' 


No.  44. 


ARCHIVES 


OF 


THE  ROENTGEN  RAY 

AND     ALLIED     PHENOMENA 

(^Formerly  Archives  of  Skiagraphy) 

PUBLISHED      BY 

REBMAN  COMPANY,  lo,  West  23rd  St.,  NEW  YORK 

REBMAN,   LIMITED,   129  Shaftesbury   Ave.,   London,  W.   C. 


CONTENTS, 


EDITORIAL:  page 

Sir  Oliver    Lodge's   Lrctures   isq 

ORIGINAL  ARTICLE: 

Lectures  to  Medical  Practi- 
tioners ON  Physics  Applied 
TO  Medicine.  By  Sir  Oliver 
Lodge,  F.R.S. 

Lecture  I.      On   Rays  in 
General        .         .         .159 

ITEMS  OF  INTEREST: 

Treatment  of  Cancer  .         .164 

X-Ray  Treatment  of  Cancer 

of  the  Uterus     .  .164 


THE    ROENTGEN    SOCIETY  pace 
MEETING,  NOVEMBER  s,  1903. 
By  Mr.  Leslie  Miller  : 

Improvements      in      Induction 
Coils   and    High-Frequency 
Resonators 
High-Frequency  Apparatus     . 


165 
109 


THE    ROENTGEN    SOCIETY 
MEETING,  DECEMBER  3,  1903.    173 

THE    ROENTGEN    SOCIETY 
MEETING,  JANUARY  7,   1904. 
The    Revelations   of   Radium. 
By  Dr.  George  B.  Batten    .    173 

DESCRIPTIONS  OF  PLATES      .    182 


P  L  A  1  E  S  . 

PLATE  CLXXXVII. 

Radiograph  of  Hand,  Showing    Injected 

Arteries.   By  A.  G.  Fryett,  F.R.M.S. 

(Melbourne,  Australia) 

PLATE  CLXXXVII. 

Stereoscopic      Radiographs     of     Elbow 

Joints,  Arteries  Injected.     By  A.  G. 

Fryett,  F.R.M.S.     (Melbourne, 

Australia) 


Size  of  Journal:  Royal  4to,  or  12%-x.  lo  inches. 


John  J.  Griffin  &  Sons, 


LIMITED. 

Makers  of 


SCIENTIFIC  APPARATUS. 


STATIC   MACHINES  wimshurst  machines  for 

XRAY  WORK. 

IN 

INDUCTION   COILS,   MEDICAL 

MAHOGANY     CASES  coils,  electrodes. 

FOR 

X  =  RAY  TUBES,  THERAPEUTIC 
HAND  OR  MOTOR   DRIVE.  TUBES,  RADIUM. 


2026     Sardinia     Street, 
LINCOLN'S  INN  FIELDS,  LONDON,  W.  C. 


433    STRAND,    LONDON 

MANUFACTURER  of  Optical,  Mathematical  and  Philosophical  Inslrii- 
inctits  to  the  (icivernrnent  Departments.  Apparatus  for  X-Rav  Worlc,  etc. 
INDUCTION  COILS,  APPS'S  PATENTED  INSTRUMEKITS,  small 
ami  lar.^^c  si/es.  V(M  V  hi.tiiiest  cthcicitc\-  and  diiraliilii  w  All  insi  nimiiits  miaraii- 
teed.  All  si/.es  i  in.  to  3.)  in.  stocked.  FOUR  FEET  SPARK  COILS  to 
order. 

SPECIAL  PATTERNS  will  be  made  to  order,  including  Pointless  Sec- 
tions and  Winding;,  Flat,  also  Conical,  my  186S  Patterns,  4,000  ohms  Resist- 
ance, lo-in.  Coils  to  order. 

IMPROVED  MERCURY  BREAK,  £6  6  .  This  can  he  lillrd  to  any 
Inriurtion  Coil. 

HOSPITAL  X-RAY  SETS,  complete  in  everv  detail,  from  £25  each. 
The  "Model"  set  of  X-Kay  apparatus  adopteil  (or  South  Africa  during  the  late 
war,  with   Piattcries,  Steam  .Motor,  etc. 

HIGH-FREQUENCY  APPARATUS  oi  ih,-  L.test  patierns. 

A  SPECIAL  SERIES  OF  COILS  without  Contact  Hreakcis,  etc., 
specially  mounted  in  a  plain  but  veiy  durable  matinci ,  about  two-thirds  of  cata- 
logue  prices. 

Any  of  the  abose  Coils  (illed  so  as  to  work  with   too  or  200  vcdls. 
PRICES    HER    RETURN    OF    POST. 


X-RAY   AND 
HIGH  FREQUENCY  APPARATUS. 


As  supplied  by  us  to  H.M.  Government,  Middlesex  Hospital,  King's  College 

Hospital,     The     General     Hospital,     Birmingham,     The     Cancer 

Hospital,  Fulham ;  and  the  Leading  Hospitals  and  X'Ray 

Workers  throughout  the  World. 


We  are  the  Actual  Manufacturers,  and  Guarantee  all  our 
Coils  a§:ainst  Breaking:  Down. 


Extract  tVoin  a  letter  from  a  large   Medical  Institution,   referring  to  Coil  and  complete 

Accessories : — 
"  You  will,   I  am  sure,   be  glad  to  know  that  the  apparatus  you  fixed  up  for  us 
gives  every  satisfaction;  a  great  deal  of  work  has  been  done  with  it." 


COX'S     PORTABLE     COMPLETE     OUTFIT 

as  supplied  to  H.M.  ALimiralty,  War  Office,   the  new  Royal  Yacht,  and  in  use  by  a 
large  number  of  Hospitals  and  General  Practitioners  in  ail  parts  of  the  World. 

HIGH     FREQUENCY    APPARATUS. 


N.B.— Our  INDUCTION  COILS  and  APPARATUS  are  not  only  less  costly  than 
other  makers',  but  §:ive  results  unexcelled  by  any  of  them. 


Our    /Uiisli\iU\l    Lisl    -will/  lush  iiclioiis    upon    Hoiv  lo  Work  stiil  fiec. 


Lessons  given  in  X=RAY  and   HIGH    FREQUENCY  WORK. 


HARRY  W.   COX,    Ltd.      v 

9,  10  and    II,  CURSITOR    ST.,    CHANCERY     LANE,    LONDON. 


„,J.i««»222"5    2 


